HUB PRELIM FORM
THE HUB AWARD, PRELIMINARY APPLICATION
The form is to be completed by the Group Leader (i.e. Lead Applicant).
Application summary
Application title
Name of administering organisation
Lead applicant's address at administering organisation
Department/Division
Organisation
Street
City/Town
Postcode/Zipcode
Country
Lead applicant
Lead applicant (Group Leader)
Full name
Department
Division
Wellcome Trust, 215 Euston Road, London NW1 2BE, UK T +44 (0)20 7611 8888, F +44 (0)20 7611 8545 wellcome.ac.uk
The Wellcome Trust is a charity registered in England and Wales, no. 210183. Its sole trustee is The Wellcome Trust Limited, a company registered in England and Wales, no. 2711000 (whose registered office is
at 215 Euston Road, London NW1 2BE, UK).
HUB PRELIM FORM
Organisation
Address Line 1
City/Town
Postcode
Country
Telephone No.
Email Address
Career history
Date from
(mm/yyyy)
Date to
(mm/yyyy)
Position
Organisation
Education/Training
Degrees and/or other professional education, starting with the most recent
Date
(mm/yyyy)
Qualification
Subject
Organisation
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Source(s) of personal salary support
Experience relevant to this proposal
Please summarise your key achievements and experience which are relevant to this proposal (350
words max.)
List of recent significant outputs
Please list up to 20 of your most significant outputs. These could include, for example, peerreviewed publications, preprints, policy consultations, public engagement events, exhibitions or
films/documentaries.
For academic publications, provide the citation in full, including title of publication and all authors*.
Citations to preprints should state “Preprint”, the repository name and the articles persistent identifier
(e.g. DOI).
(*All authors, unless more than 10, in which case please use ‘et al’, ensuring that your position as
author remains clear.)
Current and recent funding (including Wellcome Trust grants)
Please list all held in the last five years and any key prior grants (list the most recent first). State the
name of the awarding body, name(s) of grantholder(s), title of project, amounts awarded, your role in
the project, and start and end dates of support. For all active grants, indicate the number of hours
per week that are spent on each project.
Leadership
Please describe your leadership and management experience, including your experience of delivery,
financial management and people management; and your understanding of communications.
Applicants
This section is to be completed by all Core Group Members and duplicated as required
Applicant (Core Group Member)
Full name
Department
HUB PRELIM FORM
Division
Organisation
Address Line 1
City/Town
Postcode
Country
Telephone No.
Email Address
Career history
Date from
(mm/yyyy)
Date to
(mm/yyyy)
Position
Organisation
Education/Training
Degrees and/or other professional education, starting with the most recent
Date
(mm/yyyy)
Qualification
Subject
Organisation
HUB PRELIM FORM
Experience relevant to this proposal
Please summarise your key achievements and experience which are relevant to this proposal (350
words max.)
List of recent significant outputs
Please list up to 10 of your most significant outputs. These could include, for example, peerreviewed publications, preprints, policy consultations, public engagement events, exhibitions or
films/documentaries.
For academic publications, provide the citation in full, including title of publication and all authors*.
Citations to preprints should state “Preprint”, the repository name and the articles persistent identifier
(e.g. DOI).
(*All authors, unless more than 10, in which case please use ‘et al’, ensuring that your position as
author remains clear.)
Current and recent funding (including Wellcome Trust grants)
Please list all held in the last five years and any key prior grants (list the most recent first). State the
name of the awarding body, name(s) of grantholder(s), title of project, amounts awarded, your role in
the project, and start and end dates of support. For all active grants, indicate the number of hours
per week that are spent on each project.
Proposed contractual relationship to the Group Leader’s organisation in the event that
the application is successful, e.g. secondment, consultancy
Details of proposal
Project summary
Please provide a summary of the aims of the project(s) and/or the question(s) you seek to explore,
explaining their relevance to the Wellcome Trust (no more than 100 words)
Project proposal (1,500 words maximum)
Please provide details of your proposed project, including explanations of:
•
the project’s aims and objectives
•
its background and rationale
•
the interdisciplinary nature of the project’s theme and how it will enable innovation
•
the collaborative nature of the project (describing the collaboration between and beyond
HUB PRELIM FORM
•
•
•
•
Group members)
the proposed programme of work
the benefits of the team residing within Wellcome Collection
the intended audiences, outputs and/or outcomes
envisaged outputs and/or outcomes which would not have otherwise been achievable.
Approximate costs
Please provide an approximate budget for the project. Costs must be entered in Pound Sterling.
Core staff salaries (Group Leader and
Core Group Members)
Additional staff salaries
Materials and consumables
Equipment
Miscellaneous
Total (£)
Please specify the percentage of time that the Group Leader and each Core Group Member will work
on the project.
Additional information
Please add anything else you wish to say in support of your application
(500 words max)
Hearing about the scheme
Where did you find out about this scheme? Please select one of the following:
Advert
Colleague
Exhibition/conference/event/webinar
Online search
HUB PRELIM FORM
Presentation by Wellcome Trust staff
Wellcome Trust electronic newsletter
(e.g. Grantholders Newsletter)
Request for follow-on funding
Social media
Wellcome Trust electronic newsletter
(e.g. Funding Newsletter)
Wellcome Trust flyer
(e.g. Wellcome News)
Wellcome Trust staff (in person)
Wellcome Trust website
Other website
(please specify)
Other
(please specify)