2017 Otago Innovation $60,000 Proof of Concept Grant Application Form CLOSING DATE: 5pm MONDAY 15 MAY 2017 Please check this box to confirm you have read the ‘Terms and Conditions’, at the back of application form before submitting. APPLICANT DETAILS: First Investigator: Telephone: Department: E-mail: Second Investigator: Telephone: Department: E-mail: Third Investigator: Telephone: Department: E-mail: 1. PROJECT TITLE 2. TECHNOLOGY DESCRIPTION Please provide a description of your technology. (250 words max) 3. RESEARCH TO DATE Briefly describe the research you have undertaken to validate the technology. (250 words max) Page 1 of 4 CONFIDENTIAL 4. PROJECT FUNDING HISTORY Please list all historical funding for this project. Funder/Company Name Funding dates Financial Contribution 5. EXTERNAL RESEARCH COLLABORATORS Please list any external collaborators that you are working with on this project or have worked with historically. Institution/Organisation Name of Collaborator Related Agreements (CDA, MTA, collaboration agreement etc) 6. STUDENT INVOLVEMENT Please list any students who are collaborating on this project. Has the student(s) signed a University of Otago Student IP agreement? Student Name Level (PhD, Bachelors) Subject IP agreement signed? Y/N 7. PROOF OF CONCEPT REQUIRED Provide a brief description of the work required to further your research and how, if successful, you would use the Otago Innovation Proof of Concept Grant. Please include project timelines and key milestones together with funding requirements for each stage. (500 words max) 8. HOW IS YOUR TECHNOLOGY UNIQUE? Page 2 of 4 CONFIDENTIAL Describe why your technology is different to other technologies under development or available for commercial sale? Have you or anyone else working in this area published or presented material relating to your technology? If so, then please list publications including posters and conference abstracts. (250 words max). 9. WHAT COMPETITIVE ADVANTAGE DOES YOUR TECHNOLOGY CONFER? Describe how your technology is better than existing products or services in the same technology area. For example, is it cheaper to manufacture, faster, more accurate or meet an unmet need? (250 words max) 10. COMMERCIAL MARKET Who would buy the finished product? What might someone be willing to pay for your technology or service? How big is the market? (250 words max) 11. WHO SELLS COMPETING PRODUCTS/SERVICES? Please list any companies you know who sell similar or competing products or services, or any researchers working with a similar technology. (250 words max) Judging days are Monday 29 and Tuesday 30 May, please keep these days available should you be short-listed. If you need any assistance in completing the form please contact Jodie Ludwig ([email protected]) Please e-mail completed applications to: [email protected] Page 3 of 4 CONFIDENTIAL Otago Innovation Ltd Proof of Concept Grant 2017 Terms and conditions To be eligible for the grant applications must be submitted on the application form which is available on our website or from your Research Advisor. In addition to the submission of the application form, the finalists will make an oral presentation to a judging panel. Am I eligible? To be eligible to enter the grant, at least one competitor must be employed at the University of Otago as an academic staff member. Alternatively a competitor may be enrolled at the University of Otago as a student and apply with the support of their academic supervisor. An application will not be eligible to win the grant if the application relates to a technology that has already received investment from Otago Innovation. How many applications can I submit? There is no restriction on the number of applications a competitor may submit, provided that each application is materially different from any other application made by that competitor. If I win, how is the grant money made available to me? The cash element of the grant is usually paid to the competitors as a series of payments made against agreed milestones. The typical process that this follows is: The grant winner(s) prepare a development plan for their project which includes project timelines and key milestones that sets out how the money is intended to be spent; The development plan and budget is discussed and approved by Otago Innovation; A final report is submitted to Otago Innovation outlining the research achieved with the grant. Is my grant application confidential? Otago Innovation treats all applications as confidential and will not share these with other competitors or third parties without prior agreement by the applicant. Judges will also be bound by confidentiality, as will invited potential investors. The grant winner and Otago Innovation will agree upon the wording of a non-confidential summary of the application that may be used in a press release to announce the winner. Page 4 of 4 CONFIDENTIAL
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