Cover Page NSC-TFRI International Collaborative Research Proposal Title of Proposal (Chinese): _______________________ Title of Proposal (English): _______________________ Project Period: _____________________ Principal Investigator (Chinese): ____________________________ Principal Investigator (English): _____________________________ Participating Institutions: _____________________________ Project Discipline________________________ form NSC-TFRI-00 Table of Contents Cover Page (Form NSC-TFRI 00) I. General Information (Form NSC-TFRI01) a. Canadian Lead Investigator (Form NSC-TFRI01A) II. Requested Budget for Entire Term of Project (Taiwan) (Form NSC-TFRI 02) a. Requested Budget for Entire Term of Project (Canada) (Form NSC-TFRI 02A) b. Budget Justification (Form NSC-TFRI02B) III. List of Research Projects (Form NSC-TFRI 03) IV. Lay Abstracts and Keywords (Form NSC-TFRI 04). a. Scientific Abstract (Form NSC-TFRI04A) b. Collaboration Rationale (Form NSC-TFRI04B) V. Detailed Description of Proposed Research (Form NSC-TFRI05) VI. Curriculum Vitae (Form NSC-TFRI 06) VII. Research Projects Executed within the Past Three Years (Form C013) VIII. International Cooperative Research (Form I001~I003) NSC-TFRI International Collaborative Research Proposal I. General Information NSC-TFRI Joint Research Project in Cancer Type of Project Individual Research Project Dept. of Natural Sciences Mode of Research Area of Research Integrated Research Project Institution/Department Principal Investigator (PI) Research Title Position Identification Number Project Chinese English Integrated Research Project Title Chief Investigator of Integrated Research Project Identification Number Project Period Project Discipline Discipline Code Discipline □ Pure basic research □ Oriented basic research □ Applied research □ Experimental development Number of grant proposals submitted this year (including pre-approved projects and excluding proposals submitted by co-PIs): __________ Of all grant proposals submitted this year (as indicated above), indicate priority ranking for this proposal (do not repeat ranking): This is an international collaborative research project, Please complete Forms I001 through I003 Type of Research Does this project require the use of ocean research vessels? No Yes (Please complete Form C014) Does this research project include the following? (Check as applicable and attach relevant consent forms.) Human Studies/ Human Specimen Human Embryo/ Human Embryonic Stem Cell Gene Recombination / GMO Field Trial /Microbes in Risk Group 2,3,4 Animal Studies Contact Information Name: Telephone: (Office) (Home/Mobile) Mailing Address Fax Number Form NSC-TFRI 01 Signature of Principal Investigator (applicant): E-mail Page ____of ____pages Date: NSC-TFRI International Collaborative Research Canadian Lead Investigator Ia. General Information NSC-TFRI Joint Research Project in Cancer Type of Project Individual Research Project Mode of Research Area of Research Integrated Research Project Institution/Department Principal Investigator (PI) Research Project Title Position Chinese English Integrated Research Project Title Chief Investigator of Integrated Research Project Project Discipline Discipline Code Type of Research □ Pure basic research □ Applied research Identification Number Discipline □ Oriented basic research □ Experimental development Does this research project include the following? (Check as applicable and attach relevant consent forms.) Human Studies/ Human Specimen Human Embryo/ Human Embryonic Stem Cell Gene Recombination / GMO Field Trial /Microbes in Risk Group 2,3,4 Animal Studies Contact Information Name: Telephone: (Office) (Home/Mobile) Mailing Address Fax Number Form NSC-TFRI 01A E-mail Page ____of ____pages Signature of Principal Investigator (applicant): Date: Signature of Institutional Representative: Date: Ⅱ. Requested Budget for Entire Term of Project Period (Taiwan): Unit: TWD 1,000 Project Year 1st Year 2nd Year 3rd Year (2013/01/01- (2014/01/01- (2015/01/01- Budget Categories 2013/12/31) 2014/12/31) 2015/12/31) Total for Entire Term of Project Period General Expenses Personnel in Taiwan Consumables in Taiwan Travel Expenses to Canada Equipment Travel Expenses for International Destinations Overhead Total for Each Year (1,000 TWD = CDN$33) Postdoctoral Research Fellows ____ persons ____ persons ____ persons ____ persons Form NSC-TFRI 02 Page ____of ____pages Support Available / Requested from other Taiwanese Sources for Entire Term of Project Period: Indicate support from the participating institutions or other funding agencies (including industrial support). Leave space blank if not applicable. Supporting Institution (including participating institutions and other funding agencies) Items Funded Amount of Funding Funding Period (personnel, equipment, etc.) 1. Signature of the administrator of supporting institution: __________________________ (Or attach other evidence of support) 2. Signature of the administrator of supporting institution: __________________________ (Or attach other evidence of support) 3. Signature of the administrator of supporting institution: __________________________ (Or attach other evidence of support) 4. Signature of the administrator of supporting institution: __________________________ (Or attach other evidence of support) Form NSC-TFRI 02 Page ____of ____pages IIa. Requested Budget for Entire Term of Project Period (Canada): Unit: CDN$ Project Year 1st Year 2nd Year 3rd Year (2013/01/01- (2014/01/01- (2015/01/01- Budget Categories 2013/12/31) 2014/12/31) 2015/12/31) Total for Entire Term of Project Period General Expenses Research Personnel in Canada Research Consumables in Canada Travelling Fellowship(s) to Taiwan Travel Expenses to Taiwan Travel Expenses for International Destinations Total for Each Year (1CDN$=30TWD) Postdoctoral Research Fellows ____ persons ____ persons ____ persons ____ persons Use asterisk(s) above (*) to identify budget items which will be covered from other sources than TFRI, and provide more details of the funder on the next page. The TFRI request should not exceed CDN$50,000 per year. Form NSC-TFRI 02A Page ____of ____pages Support Available / Requested from other Canadian Sources for Entire Term of Project Period: Indicate support from the participating institutions or other funding agencies (including industrial support). Leave space blank if not applicable. Supporting Institution (including participating institutions and other funding agencies) Items Funded Amount of Funding Funding Period (personnel, equipment, etc.) 1. Signature of the administrator of supporting institution: __________________________ (Or attach other evidence of support or status of that support) 2. Signature of the administrator of supporting institution: __________________________ (Or attach other evidence of support or status of that support) Form NSC-TFRI 02A Page ____of ____pages IIb. Budget Justification Provide a short justification for each budget line item (Taiwan/Canada) Form NSC-TFRI 02B Page ____of ____pages Ⅲ. List of Research Projects Categories Principal Investigator Institution/ Department Position Research Project Title Percent of Effort* Main Project Sub-project 1 Sub-project 2 Sub-project 3 Sub-project 4 ‧ ‧ ‧ . ‧ ‧ *Percent of effort is defined as the percentage of the hours devoted to this project to the total working hours per week. For instance, 50% means this individual will devote a half of his/her working hours to this research project each week. Form NSC-TFRI 03 Page ____of ____pages Ⅳ. Lay Abstracts and Keywords (Please use the font type of Times New Roman, 12 points, single-space, limited to 1 page) Keywords: Form NSC-TFRI04 Page ____of ____pages IVa. Scientific Abstract (Please use the font type of Times New Roman, 12 points, single-space, one page maximum) Provide a scientific summary of the proposed research. Describe the scientific objectives of the project(s), the methodology to be used, and plans to integrate the results of the collaboration) Form NSC-TFRI04A Page ____of ____pages IVb. Collaboration Rationale (Please use the font type of Times New Roman, 12 points, single-space, one page maximum) Provide reasons (1) why the applicants propose to work together, and what are the advantages of working together towards the goals? (2) what will each applicant bring to the collaboration and what work will be done together? (3) how will the work be done, and by whom? (4) define key performance indicators and milestones against which project progress can be measured. Form NSC-TFRI04B Page ____of ____pages Ⅴ. Detailed Description of Proposed Research (Please use the font type of Times New Roman, 12 points, single-space, maximum of 15 pages) Overall description of the proposed research project: please explain why this research project should be funded. The contents should include, but not limit to, the background of the proposed studies, the scientific significance, the specific aims and the research approaches of the proposed project. Please also state the research capacities of the involved research personnel and institutes. State the milestones and deliverables for each project. Form NSC-TFRI 05 Page ____of ____pages VI. Curriculum Vitae (Required for all PIs and co-PIs of the main and sub-projects; 5-page limit for each CV) (Canadian Investigators may attach the NCI biosketch of their CV to the proposal Provide the following information: 1. Personal information. 2. Education. 3. Current position and relevant experience. 4. Fields of specialty (limit to fields related to research). 5. Major awards and honors. 6. Publication list in the past five years, including technical reports, patents, periodical articles, or books related to the project. 7. Research projects executed in the past five years. Form NSC-TFRI 06 Page ____of ____pages VII . Research Projects Executed within the Past Three Years (List all projects conducted within the past three years) Title of Research Project (For NSC grant applications, indicate grant number) Form C013 Role/ Position Duration (MM/YY~ Funding or Sponsoring Project Status Institution Total Expenses MM/YY) page___ of ___ pages IX. International Collaborative Research Projects 1. General Information about Canadian collaborator: Principal Investigator Institution □Single country: ____________________ Collaborating Countries □Multiple countries, main country: Other Countries: 1.__________ 2.__________ 3.__________ 4.__________ Name of Project at Chinese Cooperating Institution English Name (English):________________ Principal Investigator at Cooperating Institution (Chinese): ________________ Title (English):____________________________________________ Tel:__________________ Fax:_______________ E-mail:___________________ Institution (English): ____________________________ (Chinese): ____________________________ Status of Research Project at Cooperating Institution □ Under review □ Authorized, total amount (convert to NT) $ __________ thousand, for _____ years. Entire Project duration: From to (yyyy/mm/dd) □Taiwanese personnel travel abroad for research Mode of Cooperative Research (Check as applicable) □ Foreign personnel travel to Taiwan for research □ Personnel from all sides travel to a third country for research □ Taiwanese personnel travel abroad to access valuable instrumentation or equipment Equipment (please specify): ____________________________ Site (country/city/institution): ______________________________ □Data collection sharing Type of Cooperative Research (Check as applicable) □Research information exchange □Model of theory establishment and inspection □ Data induction or deduction □ Device or product design □Others (please specify) ________ □ Not included □Settled (check all that apply): Copyright □Joint publication of research results □Joint application for patent rights □Technology transfer Form I001 page___ of ___ pages 2. Expenses for International Collaborative Research Projects: 1. Funding will be provided for one overseas trip per year. Please indicate type as A, B, or C: A. Request funds for Post-doctoral research fellow or Ph.D. graduate student to travel abroad B. Request funds for PI or co-PI to travel abroad C. Request funds for foreign principal research or assisting research personnel to travel to Taiwan(for bilateral cooperate projects) 2. Fill in separate itinerary and travel route for each person, should these be different. 3. Airplane ticket and living and other expenses must be calculated according to “Dispatching of Personnel by Central Agencies for Study, Conduct Research, Practical Training Abroad Items and Amount of Subsidy Form (http://www.nsc.gov.tw/int/public/Data/082711442771.doc),” NSC Standard Per Diem Subsidies for International Experts and Scholars Visiting Taiwan for Bilateral Cooperation Activities,” and NSC Bilateral Cooperation Projects guideline. 4. Convert all currencies to NT$, add up and fill in total, indicate exchange rate. 5. For multi-year research projects, fill in separate forms for each year. Name of Research Personnel Role in Project Type (A, B, or C) Country City Duration of Stay Functions and Duties Travel Budget Item Type A Type B Type C Justifications Transportation Living Expenses Others Total Form I002 page___ of ___ pages 3. Abstract of International Collaborative Research Projects: 1. 2. Briefly state the significance and aim of project. Describe in detail the division of labor. Additionally, please merge the following documents, including (a) cooperating institute’s project abstract, (b) English application form for bilateral international project, (c) cooperating principal investigator’s CV, and (d) any other reference materials drafted or signed by both sides, into one PDF file and upload from the I004 section for review. 3. If the sponsoring organization at the cooperating institution does not have a bilateral agreement with the NSC, please provide the organization’s website address or any background information. 4. If the project is a part of an NSC Program Plan or a Project Plan, indicate the role and status of project within the Program Plan or Project Plan. 5. Applicants planning to travel abroad in order to utilize special large-scale or valuable equipments must indicate in detail the necessity of the equipment, as well as the equipment name, institution, and address of institution. 6. Describe the method and aim of research, and equipment use for each research personnel. Form I003 page___ of ___pages
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