Type of Funding applied for:- Field Trial Innovation Fund
Section A: Details of applicant(s) Please complete in block capitals
Name of business:
Contact name (in full):
Address:
Postcode: / Telephone No:
E-mail:
Producer Processor/Marketer Other (please state)
Note: if more than one category applies, please categorise in the context of this application
Section B: Details
Proposed title:
Associated AHDB supporting staff member:
(NOTE: Applications will not be processed without an associated KE manager)
Trial Objective - Please clearly state what do you expect the to achieve and why (Must be achievable and fit within the AHDB PorkBusiness plan):
Description of trial (Technical Quality):
Envisaged value to the industry:
Development of skills/expertisefrom the trial:
Proposed start date: / Proposed finish date:
What, if any, areas of the trial are considered commercially confidential?
Section C: Finance
(Identify project expenditure in sufficient detail, eg, project management costs, travel costs, equipment, training, consumable materials, consultancy fees etc.)
Total amount of funding requested:
Expenditure needs:
Description / Total cost / Grant requested
Section D: Declaration and signatures
- I declare that the proposal would not be carried out, or would be significantly reduced in scale or delayed in implementation, without the grant.
- I accept that it is my responsibility to ensure that I (or my organisation) do not breach EU State Aid rules in the use of this grant money and I declare that I will provide AHDB Pork with full and accurate information on request to enable AHDB Pork to assess this.
- I consent to the use by AHDB Pork, in general reports about the Scheme and in publication of the results of this project, of information provided in connection with this proposal, on the understanding that my declared commercial confidentiality will be protected.
- I declare that I have read and understood the Scheme conditions and that I am authorised to sign this application.
Print /
Sign
/ DateApplicant
Regional KE Manager
Senior Technical Manager
Tech Sub-Group/PHWC/Board (delete as appropriate)
This project has been approved (tick)
Warning
Any person who knowingly or recklessly makes a false statement for the purpose of obtaining grant under this Scheme or assisting another to obtain a grant may be prosecuted. Any grant obtained in contravention of the rules may have to be repaid.Please return to: Charlotte Evans, AHDB Pork, Stoneleigh Park, Kenilworth, Warwickshire, CV8 2TL.
Tel: 0247 647 8627 Email:
INTERNAL USE ONLY
AHDB Supporting staff memberNominated AHDB Project Manager
AHDB sign off required by
Please insert the SMART objectives (specific; measurable; achievable; realistic; timely) in the table below:
Description / Date expectedThe project plan table below is designed to assist with planning of AHDB or any other needed resources, physical, human or financial. A detailed project plan will be drawn up should the project go ahead.
Month / Event / Payment / Resource (who/time req) / CommsAdditional Notes
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APPLICATION FORM(V1 – 01-06-2016)