Seed Money Grant / Latin America 2015/ Application Form

Latin America - Exploratory Mandate

SEED MONEY GRANTS

APPLICATION FORM

Part 1: GENERAL INFORMATION

1)Basic Data

Project title
Keywords
Swiss institution
Latin Americaninstitution
Partner country
Short summary
(5 lines)
Total funding requested(in CHF)

I hereby confirm that all the information given in this application and the attachments is correct to the best of my knowledge

------

Place, date / Swiss Principal Investigator
------Place, date / ------Latin American Principal Investigator

2)Personal Data

2.1 Swiss PrincipalInvestigator

Family name
First name(s)
Academic degree
Date of birth
Gender
Nationality
Institution/Department/Lab
Address
Zip code/city/country
E-mail
Phone number

2.2 Latin AmericanPrincipalInvestigator

Family name
First name(s)
Academic degree
Date of birth
Gender
Nationality
Institution/Department/Lab
Address
Zip code/city/country
E-mail
Phone number

2.3Swiss and/orLatin American co-investigator(s) (additional participants)

Please insert additional tables into the document to list all co-investigators

Family name
First name(s)
Academic degree
Date of birth
Gender
Nationality
Institution/Department/Lab
Address
Zip code/city/country
E-mail
Phone number

3)Funding

3.1. Requested funding for Swiss partner(s)

Budget head / Details / Total costs (CHF)
  1. Salaries (only partial salaries may be granted for the preparation of a joint project proposal[1])

  1. Travel expenses (flight: only economy class can be requested)

  1. Accomodation costs and living expenses

  1. Consumables and equipment

  1. Event organization (workshop, conferece, other)

  1. Other project related costs[2]

TOTAL (CHF)

3.2. Requested funding forLatin Americanpartner(s)

Budget head / Details / Total costs (CHF)
  1. Salaries (only partial salaries may be granted for the preparation of a joint project proposal)

  1. Travel expenses (flight: only economy class can be requested)

  1. Accomodation costs and living expenses

  1. Consumables and equipment

  1. Event organization (workshop, conferece, other)

  1. Other project related costs

TOTAL (CHF)

3.3. Total requested Seed Money Grant

Item / (CHF)
Total requested funding for Swiss partner(s)
Total requested funding for Latin American partner(s)
Total requested Seed Money Grant

3.4. Co-funding and in-kind contributions from Swiss and Latin American partners

Co-funding

Budget head / Swiss partner(s) (CHF) / Latin American partner(s)
(CHF) / Third party(if any)(CHF)
  1. Salaries

  1. Travel expenses

  1. Accomodation costs and living expenses

  1. Consumables and equipment

  1. Event organization

  1. Other project related costs

TOTAL (CHF)

In-kind contributions

Budget head / Swiss partner(s) (description) / Latin American partner(s) (description) / Third party (if any) (description)
  1. Working time

  1. Local hospitality (accommodation and living)

  1. Use of consumables, equipment and infrastructure

  1. Event organization /hosting

  1. Other project related costs

Part 2: research and collaboration plan (max. 5 pages)

1)Summary (max. ½ page): Briefly describe the objectives, research plan, and expected results of the proposed project.

2)Objectives and justification (max. 1 page): Describe in detail the objectives of the proposed project. Statethe main research questions that will guide the implementation.Briefly discuss the relevance and originality of the topic and the significance of the expected results.

3)Research plan and timeframe(max. 2 pages): Explain the approach and methods of investigation to conduct the proposed research. Describe the activities to be performed. Outline the timeframe that will be followed indicating the major milestones.

4)Experience of the applicants and partnership aspect (max. ½ page): Outline the previous work and performance of the applicants in the proposed area of research. Briefly describe their strengths and complementarities. Describe existing research collaboration between the Swiss and Latin American partner institutions (if any).

5)Expected impact and follow-up activities (max. 1 page): Explain the expected impact and follow-up activities of the proposed research. If the grant will serve for preparation work of a new research proposal, please indicate to which call and funding agency the research team plans to submit it.

6)Promotion of female and young researchers (max. ½ page): Briefly describe the gender balance of your project and how it includes and promotes female and young researchers from both sides.

7)Ethical, safety and regulatory issues: Does the proposed work raise ethical, safety or regulatory issues? If yes, how will you deal with it?

ATTACHMENTS

In addition to thisapplication form, please provide:

  • A brief curriculum vitae (max. 2 pages) for all applicants including a list of the five most important publications related to the proposed research.
  • Letter fromthe Dean, Chair or Head of the involved institutes (for Swiss institutes only) stating support for the proposed activities and certifying that there will be no overhead or other indirect costs charged.

Contact

Dr. Gabriela Tejada, Programme Leader

Ms. Caroline Cherpillod, Programme Assistant

EPFL CODEV
CM2 248, Station 10
CH-1015 Lausanne, Switzerland

Telephone: +41 21 693 14 23

Email:

1

[1] Partial salary costs may be covered for the preparation work of a new research proposal to be submitted to a larger funding agency. Please indicate to which call and which agency the research team plans to submit the proposal.

[2] Other project related costs cannot exceed 30% of total requested budget.