December 2016
APPLICATION FORM - NWO VISITORS TRAVEL GRANT
Applications are admissible only if they are made by a host researcher attached to a Dutch research institute.
1 Details of applicant/host researcher attached to a Dutch research institute
Title(s):
First name:
Initials:
Prefix:
Surname:
Gender: male/female
Place and date of birth:
Present institute:
Position at the institute:
Field of study and specialism:
Correspondence work address:
Telephone:
E-mail:
2 Details of the guest researcher you want to invite
Title(s):
First name:
Initials:
Prefix:
Surname:
Gender: male/female
Place and date of birth:
Academic degrees:
Present institute:
Position at the institute:
Task and activities at his/her institute:
Field of study and specialism:
Correspondence work address:
Telephone:
E-mail :
3Ongoing Dutch research project/programme
3.1 Title of the ongoing Dutch research project/programme to which the proposed visit will contribute. In the case of NWO-funded research, please add NWO filenumber.
3.2Summary of the ongoing Dutch research project/programme specifying period,timetable and progress made so far (max. ½ - 1 page, max. 500 words)
3.3Main field of research (compulsory)of the ongoing project and this proposed contributing research visit
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:
Code + main field of research:
If applicable: add other fields of research, in order of relevance:
Code + other fields of research:
1.
2.
3.
Etc.
4Proposedresearch visit
4.1 Duration of the proposed visit
From (starting date) …………… to (completion date) ………. Total duration ……………… days/weeks/months. (delete as applicable)
4.2 Host institutionand name host researcher
4.3 Researchers with whom the visitor will cooperate in the Netherlands
4.4Workplan for the visit
4.4.1 Describe the topic and objective of this visit.(max. 3 pages A4 of 500 words)
4.4.2 Provide a timetable for the guest’s activities and state reasons for the period requested. (max. 1500 words)
4.5What specific contribution will the visitor make to the ongoing Dutch research project/programme at your
institute or laboratory? Please explain the added value of the visit for the progress of the ongoing
project/programme .
4.6Why did you choose this particular guest researcher and his/her expertise?
5Knowledge utilisation
(describe briefly, max. 300 words)
Potential, including:
Describe which contribution can the research make to society and/or to other areas of science? Examples are economic, social-administrative, cultural, technological, medical or democratic areas. 'Society' is used in the sense of the entire society and therefore both the public and private sectors.
Describe which other disciplines and which organisations can benefit from the research results? This concerns users in the public and private sectors, including scientists in other disciplines. NB. If the research makes no societal contribution then you need to explain this and in that case you do not need to answer the question below about the implementation.
Implementation, including:
What is the action plan to allow the outcomes of the research project (see above) to benefit potential knowledge users?
How are the potential knowledge users involved (or how will they be involved) in the research project? Here you should consider whether the tasks are clearly divided in advance, whether the parties concerned have been involved in articulating the research question, how they can contribute to achieving the societal objectives and how the ongoing involvement with users will be safeguarded. Examples are user committees, matchmaking, consortia/networks, public-private partnerships (PPP), contract research.
If a researcher is of the opinion that the proposed research is not appropriate for knowledge utilisation then he/sheshould explain why he/she thinks that knowledge utilisation is not applicable. The selection committee will assess the arguments given for this.
6Plan and budget for this research visit
6.1 Budget requested
International travel expenses
(max. € 500 within Europe, otherwise max. € 1,500)
From (country, city) ………………………………………………
To (country, city) ………………………………………………….
Expected travel costs:€ ------
Subsistence
(max. € 2,000/month for a full professor, max. € 1,750/month for other researchers)
Duration of the visit: ………………days/weeks/months (delete as applicable)
Expected subsistence costs: € ------
______
Total budget requested:€
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6.2Has any financial support for this visit been requested from organisations other than NWO?
If yes: have financial commitments been made by any of these organisations?
If yes: state organisation(s) ------
Amount(s): € ------
7CVs of applicant hostand guest researcher
7.1Please enclose a short Curriculum Vitae for the applicant and host,including degrees, appointments, positions held, and the 5 most relevant publications.(max. 3 pages A4of 500 words)
7.2Please enclose a short Curriculum Vitae for the guest researcher,including degrees, appointments, positions held and his/her 10 most relevant publications.(max. 5 pages A4of 500 words)
7.3Has your guest already received a NWO Visitors Travel Granton a previous occasion?
Yes/no
If yes: how many times? …… In which year the most recent visit was finished? ……
In case the guest has visited the applicant before, please give titles of published/soon expected output of the most recent visit(s):
……
8Signature of the Dutch applicant
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).
Place:Date:Signature:
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