Vernieuwingsimpuls /
Innovational Research Incentives Scheme
Grant application form (pre-proposal) 2014
Please refer to Explanatory Notes when completing this form
Vici scheme
Non-expert summary
Please provide as a separate file (max. 400 words, PDF) an English non-expert summary.
This summary is only meant for the science wide assessment committee and will not be
sent to external reviewers. Therefore, please upload it separately with your
application via the electronic system Iris. The scientific summary in the grant
application form (1c) is part of the application and will be sent to external reviewers.
Finally, the public summary (1i of the form) is meant for publication on our website in
case your application is successful.
Registration form (basic details)
1a. Details of applicant
- Title:
- First name:
- Initials:
- Prefix:
- Surname:
- Male/female:
- Address for correspondence (for the period of the Vici-round):
-
Preference for correspondence in English: yes/no
Telephone:
Cell phone:
Fax:
Email:
Website (optional):
Doctorate (date, dd/mm/yy):
Use of extension clause (see Notes): yes/no
(give reasons and calculation. Please note: you need to formally request extension before
the deadline!)
1b. Title of research proposal
1c. Scientific summary of research proposal
(max. 300 words)
1.d Keywords
(max. 5 keywords)
1e. Host institution (if known)
1f. NWO domain (choose one)
Alpha and Gamma Sciences
Physical Sciences and Engineering
Life Sciences
1g. NWO Division (choose one)
ALW
CW
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Vernieuwingsimpuls /
Innovational Research Incentives Scheme
Grant application form (pre-proposal) 2014
Please refer to Explanatory Notes when completing this form
Vici scheme
EW
GW
MaGW
ZonMW
N
STW
In case your proposal has affinity with more than one NWO division, please indicate
below which one(s):
1h. Main field of research (compulsory)
If applicable: add other fields of research, in order of relevance
Main
Other
Code
Fields of research
1i. Public summary of your research proposal (max. 50 words; preferably in Dutch).
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Vernieuwingsimpuls /
Innovational Research Incentives Scheme
Grant application form (pre-proposal) 2014
Please refer to Explanatory Notes when completing this form
Vici scheme
Research proposal
2a1 and 2a2. Description of the proposed research
(max. 1200 words on max. 3 pages, see Notes)
2a1. Overall aim and key objectives including:
Scientific relevance and challenges
Originality and innovative character
Methods and techniques
2a2. Research plan including:
Practical timetable/timeline over the grant period
Local, national and international collaboration
Workplan for requested personnel
2b. Knowledge utilisation
(max. 500 words, see Notes)
Potential, including:
- contribution to society and/or other scientific areas;
- disciplines and organisations that stand to benefit from the results.
Implementation, including
- action plan to allow the outcomes of the research project to benefit the potential
knowledge users,
- or and if yes, how the potential knowledge users will be involved,
- (concrete) outcomes for society,
- expected horizon for possible knowledge utilisation
2c. Number of words used
section 2a1 and 2a2 _____________ (max. 1200 words)
section 2b ______________ (max. 500 words)
2d. Literature references
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Vernieuwingsimpuls /
Innovational Research Incentives Scheme
Grant application form (pre-proposal) 2014
Please refer to Explanatory Notes when completing this form
Vici scheme
Cost estimates
3a. Budget
Description
Year
Year 2
Year 3
Year 4
Year 5
Total
1*
Staff
FTE*
Months*
WP*
Applicant
..
..
..
..
..
..
..
NWP*
..
..
..
..
..
..
..
..
..
..
..
..
..
..
..
..
..
..
..
..
..
..
..
..
..
..
..
..
..
..
..
..
..
..
..
..
..
..
..
..
..
..
..
..
..
..
..
..
..
..
..
..
..
..
..
..
..
..
..
..
Total Other
..
..
..
..
..
Grand total
..
..
..
..
..
Total Staff
Equipment
..
Total
Equipment
Investments
..
Total
Investments
Materials
..
Total
Materials
Travel
..
Total Travel
Other
..
Some notes on the table (also check the Explanatory Notes accompanying the form):
-
You can add rows under the (bold print) headings. You cannot add headings.
Years are Project Years. So for example: if your intended starting date is 1
October 2014, then Year 1 ranges from 1 October 2014 to 30 September 2015.
Etcetera.
In 3a you are asked to fill out the time you spend on your Vici (so including any
FTE that your university may pay for work on your Vici). If your university pays
(part of) the time you spend on your Vici you can indicate this in 3c.
*WP = Scientific Staff; NWP = Non Scientific Staff
3b. Cofinancing ‘in kind’
Cofinancer/party
Description
Estimated value in Euro
..
..
..
3c. Cofinancing ‘in cash’
4
Vernieuwingsimpuls /
Innovational Research Incentives Scheme
Grant application form (pre-proposal) 2014
Please refer to Explanatory Notes when completing this form
Vici scheme
Cofinancer/party
Description
Euro
..
..
..
3d. Totals
Grand total
.. (=3a)
Requested budget
.. (=3a minus 3b/3c)
3e. Intended starting date (see Notes)
3f. Have you requested any additional grants for this project either from NWO or
from any other institution, or has the same idea been submitted elsewhere?
yes/no (if ‘yes’, see Notes)
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Vernieuwingsimpuls /
Innovational Research Incentives Scheme
Grant application form (pre-proposal) 2014
Please refer to Explanatory Notes when completing this form
Vici scheme
Curriculum vitae
4a. Personal details
Title(s), initial(s), first name, surname:
Male/female:
Date and place of birth:
Nationality:
Birth country of parents:
4b. Master's (‘doctoraal’)
University/College of Higher Education:
Date (dd/mm/yy):
Studies:
Main subject:
4c. Doctorate
University/College of Higher Education:
Date (dd/mm/yy):
Supervisor (‘promotor’):
Title of thesis:
4d. Work experience since completing your PhD
Current and previous positions. Specify per appointment: period, number of fte, type of
position, and supervisory responsibilities (if any).
Position
Period
(date-date)
Number of
fte
Type of
position
(fixed term,
permanent,
tenure track,
other)
Institution
Months spent since completing your PhD (See notes for an example of the
computation)
Experience
Research activities
Teaching activities
Care or sick leave
Number of
months
Management tasks
Other, please specify:
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Vernieuwingsimpuls /
Innovational Research Incentives Scheme
Grant application form (pre-proposal) 2014
Please refer to Explanatory Notes when completing this form
Vici scheme
4e. Academic staff supervised
PhDs
Promotor/supervisor
Ongoing
Succesfully
completed
Co-promotor/cosupervisor
Subtotal
Post Docs
Subtotal
Other
Subtotal
4f. Brief summary of research over the last five years (see notes)
(max. 250 words)
4g. International activities (see notes)
4h. Other academic activities (see notes)
4i. Scholarships, grants and prizes
Please list any research scholarships/grants for which you have successfully applied or
prizes that you have won in the last five years and indicate the amount of money
involved.
Scholarship/Grant/ Prize
PI
Amount
Year of award
Subtotal
Scholarship/Grant/Prize
Co-PI
Subtotal
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Vernieuwingsimpuls /
Innovational Research Incentives Scheme
Grant application form (pre-proposal) 2014
Please refer to Explanatory Notes when completing this form
Vici scheme
Output
5a. Output indicators
Please identify the most important output indicators in your field.
5b. Output
Please number your items consecutively and also indicate the total number per category.
For publications: only mention those publications that have been published or have been
accepted for publication starting with the most recent publication. Please mark key
publications that are directly relevant to the proposed research with an S (the S stands
for significant).
-
Refereed articles
-
Non-refereed articles
-
Books
-
Book chapters
-
Patents
-
Other
5b. Top publications (See notes)
5c. Median impact factors for your own field
Compulsory if your proposal applies to the domain Life Sciences. For other NWO
divisions, this is only compulsory if you have mentioned impact factors of the journal
under question 5a (See Notes).
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Vernieuwingsimpuls /
Innovational Research Incentives Scheme
Grant application form (pre-proposal) 2014
Please refer to Explanatory Notes when completing this form
Vici scheme
Statements by the applicant
Ethical aspects
Approval from a recognised
medical ethics review committee
Approval from an animal
experiments committee
Permission for research with the
population screening Act
Not
applicable
Not yet
applied for
Applied for
Received
If applicable you need to send a copy of (one of) the aforementioned documents to NWO
when your application has been granted and before your project can start.
By signing this form I endorse the code of conduct for laboratory animals and the code of
conduct for biosecurity/possibility for dual use of the expected results and will act
accordingly if applicable.
I have completed this form truthfully.
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).
Name:
Place:
Date:
There is a possibility to send a list of non-referees (maximum of three
individuals). This is optional. Non-referees will NOT be asked to assess your
application as referees. Please upload the list with your application as a separate
PDF-file.
Please submit the application to NWO in electronic form (pdf format is required!) using
the online submission system, which can be accessed via the NWO website
(www.nwo.nl/vi). For any technical questions regarding submission, please contact the
helpdesk ([email protected]).
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