Rubicon:
Grant application form 2017
(deadline 31 August 2017, 14.00 hrs. CE(S)T)
By submitting this document, I declare that I satisfy the nationally and
internationally accepted standards for scientific conduct as stated in the
Netherlands Code of Conduct for Scientific Practice 2012 (Association of
Universities in the Netherlands).
NB: Wherever explanations are given, the applicants may delete them when filling in the
form. The headings are mandatory.
Rubicon applications will be assessed on the basis of the following quality
criteria: Quality of the applicant, Quality of the proposal, Quality of the host
institute and Knowledge exchange and impact.
0. Basic details
0a. Details of applicant
- Title:
- First name:
- Initials:
- Prefix:
- Surname:
- Male/female:
- Address for correspondence:
- Preference for correspondence in English: yes/no
-
Telephone:
Email:
Private email (optional):
Website (optional):
0b. Title of research proposal
0c. Summary of research proposal
(max. 200 words, plus max. 5 KEYWORDS)
0d. NWO Research area
Please indicate the appropriate research area
☐
☐
☐
☐
Domain Applied and Engineering Sciences
Domain Science
Domain Social Sciences and Humanities
Health research and Medical sciences (ZonMw)
0e. Main field of research
For all applications it is compulsory to fill out one or more research fields that correspond
to the subject of your research proposal. You can only refer to the descriptions and codes
from the NWO research field list. Please find the list via:
http://www.nwo.nl/researchfields.
Submit the application through:
http://www.nwo.nl/en/funding/our-funding-instruments/nwo/rubicon/index.html
Page 1 of 9
Rubicon:
Grant application form 2017
(deadline 31 August 2017, 14.00 hrs. CE(S)T)
Code + main field of research:
If applicable: other fields of research, in order of relevance:
Code + other fields of research:
1.
2.
3.
Etc.
0f. Please draft a public summary of your research proposal (preferably in
Dutch).
The summary should start giving the following data in this order: <popular title (a 'hook'
to catch people's attention, around five words> <academic title> <initials> <(the first
name you generally use, in brackets)> <surname> <(m/f)>, <institute where you
received your PhD> <country, university, department where you intend to conduct your
Rubicon research> <number of months>
Summarise your proposed research in maximum 40 words. Further instructions are given in the
Frequently Asked Questions list available at the website.
Submit the application through:
http://www.nwo.nl/en/funding/our-funding-instruments/nwo/rubicon/index.html
Page 2 of 9
Rubicon:
Grant application form 2017
(deadline 31 August 2017, 14.00 hrs. CE(S)T)
1. Curriculum vitae
The CV has a maximum of 3 pages, excluding the Possible impact of the Rubicon
project(1k) and the Publication list (1l).
1a. Personal details
Title(s), initial(s), first names (in full), surname:
Nationality:
1b. Master's (doctoraal)
University/College of Higher Education:
Faculty:
Date of the certificate:
Main subject:
1c. Doctorate (promotie)
University/College of Higher Education:
Date and place of (intended) doctoral degree as stated on your certificate:
Supervisor (‘Promotor’):
Title of thesis:
Note: If you have not yet received your PhD you must include a manuscript approval
form in your application. You can download the form from the Rubicon website.
1d. Extension clause
Indicate whether you need to make use of the extension clause. This is only necessary if
the time between your doctorate date and the Rubicon-deadline exceeds the maximum
period of 1 year. In that case, it is important to contact the programme coordinator of
Rubicon ([email protected]) before submitting your application. (See this link for more
information on the extension rule)
Yes
Not applicable
I have permission to make use of the extension
clause
Full time equivalent
Permanent position (Y/N)
Fixed term (Y/N)
1e. Current employment and work experience since graduating (see 1b)
Start date
End date
Employer
Place
Scientific
discipline
PhD
student
Postdoc
Other:
Submit the application through:
http://www.nwo.nl/en/funding/our-funding-instruments/nwo/rubicon/index.html
Page 3 of 9
Rubicon:
Grant application form 2017
(deadline 31 August 2017, 14.00 hrs. CE(S)T)
1f. Months spent on research
Give all the time you have spent on research in a total number of months. The
committee will evaluate your track record with regard to this number. If there are any
gaps in your CV, you may explain them here (for example: maternity leave, illness,
unemployment, informal care).
1g. Brief summary of pre- and/or postdoctoral research experience
(max. 300 words)
1h. International activities and extended periods of study/research abroad
If subsidised, please specify grant source.
1i. Scholarships and prizes
1j. Other academic activities
1k. Publications
The applicant's authorship of publications (such as articles in internationally
recognised academic journals) is a factor of considerable importance in the
assessment of Rubicon fellowship applications

List your five top publications including one or two sentences on what your
contribution to each publication was. Items should be listed and classified as
follows:
- author(s);
- title;
- journal (issue, year, pages, impact factor)

List all publications, lectures, abstracts and manuscripts, excluding the top five
mentioned above , including one or two sentences on what your contribution was,
but using the same classification. Categorize the list into already published,
accepted and submitted publications

Please list the top 5 journals in your research area (with impact factor).

Output indicators
Please identify the most important output indicators in your field. This will allow
peers to assess your output taking into account the standards in your research
field. Please use indicators for your publication list (first/last author;
individual/group publications; international or national orientation) or information
on what type of output is valued highest (books/journal publications/conference
proceedings/other, such as designs (for certain disciplines within design and
engineering).
1l. Possible impact of the Rubicon project on your personal career
Describe what kind of impact you expect your Rubicon grant to have (if granted) and
what your plans are after finishing the project.
Submit the application through:
http://www.nwo.nl/en/funding/our-funding-instruments/nwo/rubicon/index.html
Page 4 of 9
Rubicon:
Grant application form 2017
(deadline 31 August 2017, 14.00 hrs. CE(S)T)
2. Research proposal
Important note: Please take into account that a multidisciplinary advisory
committee will have to read and understand your proposal. Therefore we advise
you to ensure that your proposal is tailored for an audience consisting of
experts with various scientific backgrounds within the range of the research
area you have submitted to.
2a. Proposed research
Describe the proposed research as accurately as you can within the maximum number of
maximum 2000 words on no more than 6 pages, not including references; the word
count includes all texts not including references. Like figure captions, tables etc.
You must at least include information on the following subcriteria:
- the subject and aim of the research
- innovative aspect of research proposal
- plan of activities (including research timetable and phasing)
- research method(s) to be used
- current state of knowledge in the field and how the planned research will advance
this
- means of publication/dissemination of research results
2b. Literature references
List all relevant literature here and include full bibliographical details, e.g. Authors, Title
article, Title book/journal, ed., year, page nrs.
2c. Ethical aspects
Possible relevant aspects are:
- research on animals
- informed consent
- privacy and data protection
- research on human Embryonic Stem Cells
- research involving developing countries
- biosecurity/dual use
i.
Please give a summary of which measures have been or will be taken
with regard to ethical aspects of your research.
ii.
Indicate for each approval necessary whether the approval has been
received, applied for or not yet applied for:
Not
applicable
Not yet
Applied
applied for* for*
Received*
Approval from a recognised
medical ethics review committee
Approval from an animal
experiments committee
Permission for research with the
population screening Act
* You must send a copy of the applicable documents to NWO before your project can
start.
Submit the application through:
http://www.nwo.nl/en/funding/our-funding-instruments/nwo/rubicon/index.html
Page 5 of 9
Rubicon:
Grant application form 2017
(deadline 31 August 2017, 14.00 hrs. CE(S)T)
iii.
I endorse and when applicable will act accordingly:
YES
not applicable
the code of conduct for use of
laboratory animals
the code of conduct for
biosecurity/possibility for dual use of
the expected results
2d. Grant budget
i. Host institute/research outside the Netherlands
For the applicants that apply for a Rubicon grant outside the Netherlands, the
amount of the grant depends on the length of stay and the country where the host
institute is situated.
Please fill in the table below. The amounts should be based on the Standard
Payments Rubicon in the document Rubicon Terms and Conditions 2017 - July, see
the Rubicon website. NWO reserves the right to adapt the amounts if your
application will be granted.
Costs
Salary including social fees and taxes
Research costs
Travel costs
Total
Amount €
ii. Host institute in the Netherlands
For the applicants that apply for a Rubicon grant in the Netherlands, the amount of
the grant is fixed at 63.000 Euro per year. The exact amount depends on the number
of months applied for and should be spent on salary costs, social fees and taxes.
2e. Planned duration of visit
Minimum 12 months and maximum 24 months. Indicate how many months you want to
apply for and the full time equivalent (fte).
2f. If you have requested any additional grants for this project either from NWO
or from any other source, please specify the sort of grant, the amount and the
source.
Note: Should you learn the result of any such application, please inform NWO
immediately both of the outcome and of the amount of any support awarded.
2g. Any other important remarks with regard to this application
Submit the application through:
http://www.nwo.nl/en/funding/our-funding-instruments/nwo/rubicon/index.html
Page 6 of 9
Rubicon:
Grant application form 2017
(deadline 31 August 2017, 14.00 hrs. CE(S)T)
3. Host institute
3a. Employed by a Dutch institute and seconded to a foreign Host institute
Yes/No.
3b. Full name and address of the host institute
Note that there is only one host institute possible.
3c. Website of the host institute
3d. Name, position and email address of the supervisor at the host institute
See also the form of acceptance to be completed by the host institute.
3e. Describe what contacts have already been established with the host
institute (max. 200 words)
3f. Indicate why you prefer to carry out your research at the host institute
including (max. 400 words)
- Reasons for choosing this particular research group
- Reasons for choosing this particular supervisor
- In what way your research fits the already existing research line(s) at the host
institute
- Preference is given to applications at a foreign host institute. If you are applying for
a research period at a research institute in the Netherlands, please explain why you
choose that host institute above a host institute abroad
- Any other motivation for your choice of the host institute
3g. List the five key publications of the research group at the host institute over
the last five years
1.
2.
3.
4.
5.
3h. Intended starting date
No earlier than 1 March 2018, no later than 1 June 2018.
Submit the application through:
http://www.nwo.nl/en/funding/our-funding-instruments/nwo/rubicon/index.html
Page 7 of 9
Rubicon:
Grant application form 2017
(deadline 31 August 2017, 14.00 hrs. CE(S)T)
4. Knowledge exchange and impact
Max. 400 words excluding literature references or figures
In the case of research that does not lend itself to knowledge exchange and impact as
described in the aforementioned terms, the researcher is requested to explain why he or
she believes that knowledge exchange and impact is not applicable to the proposed
research.
4a. Relevance of the results and/or insights from the research for and the
contribution to solving economic, societal, cultural, policy-related or technical
challenges
4b. Describe the effectiveness and feasibility of the proposed approach for
knowledge exchange and impact with respect to meeting the need(s) of third
parties within and outside of the academic sector
4c. Indicate the period in which possible knowledge exchange and impact is
expected to occur
4d. Describe how the researcher might intend to contribute to the realisation of
the possible knowledge exchange and impact
Submit the application through:
http://www.nwo.nl/en/funding/our-funding-instruments/nwo/rubicon/index.html
Page 8 of 9
Rubicon:
Grant application form 2017
(deadline 31 August 2017, 14.00 hrs. CE(S)T)
5. Appendices and word count
Please submit the application to NWO/ZonMw in electronic form (pdf format is required!)
using the online application system ISAAC (NWO)/ProjectNet (ZonMw), which can be
accessed via the NOW/ZonMw website (www.nwo.nl/www.zonmw.nl).
Do not forget to attach the
- two mandatory recommendation forms
- the mandatory acceptance form (signed)and
- the manuscript approval form (if necessary).
Recommendation letters
Give the title(s), initial(s), surname and university of the two references expressing
support for the application on the two recommendation forms (aanbevelingsbrieven)
accompanying the application
1. Name:
Institute:
2. Name:
Institute:
The recommendation letters should preferably be submitted by the applicant through the
ISAAC/ProjectNet system but if the authors of the letters have objections to that
procedure, they may send their letters by email to [email protected]. Fill in the box,
choose yes or no.
The letters are attached to this application
The letters will be sent by e-mail to [email protected]
yes/no
yes/no
Word count (Please fill in the table below)
Exact number of words
for each of the
paragraphs:
0c
1g
2a
3d
3e
4
Maximum
number of words
allowed:
200
300
2000
200
400
400
Submit the application through:
http://www.nwo.nl/en/funding/our-funding-instruments/nwo/rubicon/index.html
Page 9 of 9