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KTP Application Form PART A single project v3.6, October 2009 / Page of 12
/ Grant Application and Proposal Form
Single Associate Project
Part A
Partnership UIN
Is this a resubmission? / Y/N / If yes, provide KTP Programme Number

Section 1 Identifier Sheet (Information in Section 1 will be put in the public Domain)

1.1 /

Knowledge Base Partner

1.2 / Which department will be providing the primary input to the Partnership
1.3 / What is the department RAE rating
1.4 / Registered Name (NOT the Trading Name) of the company[1] involved in the Partnership
Company Town
Company Postcode
1.5 / What is the proposed Project length and employment pattern for the KTP Associate?
Please mark the relevant boxes with an X.
Year 1 / Year 2 / Year 3 / Year 4 / Year 5
Q
1 / Q
2 / Q
3 / Q
4 / Q
1 / Q
2 / Q
3 / Q
4 / Q
1 / Q
2 / Q
3 / Q
4 / Q
1 / Q
2 / Q
3 / Q
4 / Q
1 / Q
2 / Q
3 / Q4
Associate 1
1.6 / Describe the work to be carried out in the proposed Knowledge Transfer Partnership and its purpose, in no more than 25 words.
1.7 / Amount of grant applied for in support of this proposal including any request for additional funds.
1.8 / Please indicate with an X the potential KTP Funding Organisation or Funding Organisations.
Advantage West Midlands / Natural Environment Research Council
Arts and Humanities Research Council / Northwest Regional Development Agency
Biotechnology & Biological Sciences Research Council / One NorthEast
Department for Environment, Food and Rural Affairs / Science and Technology Facilities Council
Department of Health / Scottish Government
East of England Development Agency / South East England Development Agency
East Midlands Development Agency / South West of England Region Development Agency
Economic & Social Research Council / Technology Strategy Board
Engineering & Physical Sciences Research Council / Welsh Assembly Government
Invest Northern Ireland / Yorkshire Forward
London Development Agency

Section 2 Partnership Strategy

2.1 / Outline the company’s business clearly stating its revenue generating activities (or funding sources if not yet generating revenues), in no more than 100 words.
2.2 / If a LARGE company or part of a GROUP:
a / Through the use of diagram or text, please illustrate the department’s position within the company or the company’s position within the group.
b / If a large company, outline how the partnership contributes to the company strategy. If part of a group, outline how the partnership contributes to the group strategy, in no more than 200 words.
c / If a large company, please state the name and function (or role) of the senior company executive responsible for the company activities impacted by this partnership. If a part of a group, please state the name (or role) of the senior group executive responsible[2].
2.3 / Briefly explain:
a / Why the partnership is strategic to the company, in no more than 250 words.
.
b / Outline the specific problems and opportunities the partnership addresses, in no more than 250 words.
.
c / Specify the knowledge and expertise the company lacks to undertake the project independently, in no more than 250 words.
.
2.4 / Summarise the project plans (e.g. incl. objectives) and outputs, in no more than 250 words.
2.5 / From the company perspective summarise the expected outcomes that will result from the project outputs, in no more than 250 words.
2.6a / Through the use of text or a diagram, where there is more than one project within the partnership describe or show how the projects relate to each other.
Question not applicable to single projects
2.6b / Please explain how the project(s) relate to other KTPs undertaken by this partnership.
Question not applicable to single projects
2.7 / Describe the key challenge for the Knowledge Base team/academic concerned and their reasons for participating in this partnership, in no more than 250 words.
2.8 / Outline (a) the challenge -including commercial exposure, and (b) the opportunities this project will provide for the Associate, in no more than 150 words.

Section 2a Company Financial Summary

2.9 / Name of the proposed Company Partner or, if appropriate, the group to which this financial information relates.
Are there any qualifications by the Company’s Auditors to these accounts? (Please mark with an X)
Yes / No
If ‘Yes’, you will need to provide a copy of the auditors’ report to the KTP Adviser advising on this Proposal.
COMPANY PARTNER ACCOUNTS
Please make clear the basis for the numbers (eg £k), and use comma separators (eg £34,567k)
DO NOT WRITE IN THE GREY BOXES! / Latest period / Last audited year / Prior audited year
1 / Period end date
2 / Sales
3 / Profit before tax
4 / No of employees
5 / Tangible assets
6 / Investments and goodwill
7 / TOTAL fixed assets (A)
8 / Stock and work-in-progress
9 / Trade debtors, prepayments
10 / Cash and bank balances
11 / Other current assets (identify below)
12 / TOTAL current assets (B)
13 / Trade creditors and accruals
14 / Bank overdraft and loans
15 / Taxation and NI and dividends
16 / Finance leases and hire purchase (less than one year)
17 / Other current liabilities (identify below)
18 / TOTAL current liabilities (C)
19 / NET current assets/liabilities (B - C)
20 / Bank Loans and similar
21 / Finance leases and hire purchase (greater than one year)
22 / Other long term creditors (identify below)
23 / TOTAL long term creditors (D)
24 / Provision for liabilities and charges (E)
25 / ASSETS EMPLOYED (A + B - C - D - E)
26 / Financed by:
27 / Share capital
28 / Profit/Loss Account
29 / Other (identify below)
30 / SHAREHOLDER FUNDS
Identification / Other current assets (line 11)
Other current liabilities (line 17)
Other long term creditors (line 22)
Other finance (line 29)
GROUP ACCOUNTS (if applicable)
NAME OF GROUP OR PARENT COMPANY FOR WHICH ACCOUNTS SUPPLIED
Please make clear the basis for the numbers (eg £k), and use comma separators (eg £34,567k)
DO NOT WRITE IN THE GREY BOXES! / Latest period / Last audited year / Prior audited year
1 / Period end date
2 / Sales
3 / Profit before tax
4 / No of employees
5 / Tangible assets
6 / Investments and goodwill
7 / TOTAL fixed assets (A)
8 / Stock and work-in-progress
9 / Trade debtors, prepayments
10 / Cash and bank balances
11 / Other current assets (identify below)
12 / TOTAL current assets (B)
13 / Trade creditors and accruals
14 / Bank overdraft and loans
15 / Taxation and NI and dividends
16 / Finance leases and hire purchase (less than one year)
17 / Other current liabilities (identify below)
18 / TOTAL current liabilities (C)
19 / NET current assets/liabilities (B - C)
20 / Bank Loans and similar
21 / Finance leases and hire purchase (greater than one year)
22 / Other long term creditors (identify below)
23 / TOTAL long term creditors (D)
24 / Provision for liabilities and charges (E)
25 / ASSETS EMPLOYED (A + B - C - D - E)
26 / Financed by:
27 / Share capital
28 / Profit/Loss Account
29 / Other (identify below)
30 / SHAREHOLDER FUNDS
Identification / Other current assets (line 11)
Other current liabilities (line 17)
Other long term creditors (line 22)
Other finance (line 29)
2.10 / How many employees (full time equivalent) are there in the group of companies controlled by the ultimate parent company or owner?
2.11 / Does any person (or persons) or company (or companies) have more than a 25 percent controlling interest in the Company Partner (other than public investment corporations, institutional investors or venture capitalists)?
2.12 / If ‘Yes’, what is the name of the ultimate parent company or owner?
2.13 / What is the annual turnover of this group of companies as stated in the last audited (if appropriate) accounts? (Please state value in £s, not £k or £M)
2.14 / What is the group’s balance sheet total as stated in its last audited (if appropriate) accounts? (Please state value in £s, not £k or £M)
2.15 / During the past five years has the company been involved in KTP? (Please mark with an X)
Yes / No
2.16 / Indicate the number of Associate Projects supported by PAG previously.

Section 3 The Business Case

3.1 / For the business areas to which the project relates, specify the target market/s and the value/s. State the company’s current position in this/these market/s and the main competitors, in no more than 250 words.
3.2 / Quantify the anticipated commercial impacts of the partnership in the table below. Examples of commercial impact are provided in the guidance notes.
Net Profit Before Tax (£)
During Project / 1 yr after completion / 2 yrs after completion / 3 yrs after completion
Total
3.3 / Demonstrate how the commercial impacts in the table above are delivered from the associated project outputs (in 2.4).

Section 4 The Project Plan[3]

4.1 / Project Work Plan for the Associate
Task No. / Task description / Effort
(months) / Outputs[4] & key decision points
1 / Knowledge Base & Company induction
Induction completed
2 / Training and development including KTP modules 1, 2, 3 and 4 and mini project (altogether calculated as 10% of total project time).
PDP planned and implemented
3 / Associate to complete detailed action plan, e.g. including a Gantt or Critical Path Network, and risk assessment, for the entire project and a detailed task list for all project stages.
Detailed action plan
4 / Associate holidays
Project Stage 1 –
Project Stage 2 –
Project Stage 3 –
Project Stage 4 –
Project Stage 5 –
Project Stage 6 –
Project Stage 7 –
Project Stage 8 –
Project Stage 9 –
Project Stage 10 –
Project Stage 11 –
Project Stage 12 –
Project Stage 13 –
Project Stage 14 –
Project Stage 15 –
Project Stage 16 –
TOTAL / Sum of total effort in months

1 of 22

Grant Application and Proposal Form (Always send forms as attachments)

Single Associate Project Part A

(Version 3.6 - October 2009)

/ Grant Application and Proposal Form
Single Associate Project
Part A
4.2Time Plan for the proposed Project work for the Associate
For each task identified at 4.1, please shade the months when this Associate will be working on that task. You should also mark target outputs and key decision points.
Project stage
/
Project Months
0-3 / 3-6 / 6-9 / 9-12 / 12-15 / 15-18 / 18-21 / 21-24 / 24-27 / 27-30 / 30-33 / 33-36 / 36-39
Knowledge Base & Company Induction
Training & Development (KTP Modules already added) / / /
Completion of detailed action plan
Holidays

1 of 22

Grant Application and Proposal Form (Always send forms as attachments)

Single Associate Project Part A

(Version 3.6 - October 2009)

/ Grant Application and Proposal Form
Single Associate Project
Part A
4.3 / Identify the actions and investments by the company required to translate the outputs from the partnership, including all projects, to project outcomes.

Section 5 The KTP Associate(s)

5.1 / State the qualifications, experience and personal attributes the Associate will require.
Qualifications
Experience
Personal attributes
5.2 / Describe the managerial and technical competencies the Associate could develop by taking part in the proposed Knowledge Transfer Partnership, in no more than 100 words.
5.3 / Outline the further professional, vocational or academic qualifications the Associate is likely to achieve as a result of completing their Project, in no more than 100 words.
Section 6 The Knowledge Base team
6.1 / Name the Knowledge Base Supervisor, state their position and qualifications, and describe the knowledge and expertise they will contribute to the project.
Name
Position & Department
Qualifications
Relevant expertise & experience
6.2 / Identify any other staff, including the Lead Academic, that will support the project, state their position, qualifications and the relevant expertise/experience they will contribute to the project.
Name / Position & Dept. / Relevant expertise & experience
6.3 / Detail any other resources that will be available to support the project.
6.4 / List and quantify the benefits that the knowledge base team expect to gain from participating in the KTP, in no more than 250 words.
6.5 / Does the project draw directly on any Research Council funding? (Please mark with an X). If Yes please provide details.
Yes / No / RC Detail:
Section 7: Project Management
7.1 / Name of the person who will lead the company partner’s input to the Knowledge Transfer Partnership, state their position in the company and their relevant expertise/experience.
Name
Position
Expertise and experience
7.2 / Name the person who will be the Company Supervisor for the Associate, state their position in the company and outline their supervisory experience.
Name
Position
Experience
7.3 / List the members of the Local Management Committee (LMC).
Name / Organisation / Position in Partner organisation / Role in Partnership
Chairman
Facilitator
Lead Academic/
Researcher
Company Supervisor
Knowledge Base Supervisor
KTP Adviser
7.4 / Project management arrangements should include weekly on-site meetings between the Knowledge Base Supervisor and the KTP Associate at the company, and monthly project management meetings at the company involving the Knowledge Base team and company staff and the KTP Associate, which will be convened and minuted by the KTP Associate. The KTP Associate should receive on average a minimum of 0.5 days per week supervision by the Knowledge Base Supervisor. Please outline any requests for alternative arrangements for project supervision.
7.5 / Explain how project achievements will be publicised and best practice spread within the Company Partner, the Knowledge Base Partner and to others. If the company partner is a large company or part of a group, please explain how the knowledge transfer will be disseminated across the organisation, in no more than 200 words.
7.6 / Have the proposed Partners (including any college or university identified at 3.14) reached an agreement on intellectual property rights in respect of the proposed Knowledge Transfer Partnership? (Please mark with an X)

Yes

/

No

7.7 / If ‘No’, will the partners reach an agreement on intellectual property rights before the proposed Knowledge Transfer Partnership is established? (Please mark with an X)
Yes / No
7.8 / If the Partnership has indicated NO to both questions 7.6 and 7.7 above please explain why no IPR agreement is considered necessary.

Section 8 Grant Funding

Please read the Guidance notes carefully before completing this Section.

Is the Knowledge Base Partner using fEC to calculate this budget? (Please mark with an X) / Yes / No
If the Knowledge Base Partner is using fEC, please confirm whether the proposal has been prepared in line with the fEC letter dated (…)[5] provided to the KTP Programme Office. / Yes / No
1. / 2. / 3.
Applicable ‘Standard Budget’ plus any increase or adjustment sought, e.g. transfer between b, c and d
(£) / Amount of grant requested
( % of amounts in column 1)
(£) / Company contribution to the ‘Budget’
( % of amounts in column 1)
(£)
Costs eligible for support
DO NOT WRITE IN THE GREY BOXES!
/ Partnership Budget
£ / Government Contribution
£ / Company’s Contribution
£
Directly Incurred costs
a. Associate(s) Employment Costs
b. Associate(s) Development*
c Travel and Subsistence*
d Consumables*
Directly Allocated Costs
e Knowledge Base Supervisor
f Associate(s) Estates costs
g Mentoring Support
Indirect Costs
h Additional Associate Support
TOTAL

Notes:

Your KTP Adviser or the KTP Programme Office can offer advice on the most appropriate ‘Standard Budget’ and explain what grant support can be offered. The Company Partner should consider ‘topping up’ the amount it contributes to the costs of employing the Associate(s) in order to recruit the Associate(s) with the appropriate level of qualifications and experience from the job market. The government contribution towards the employment costs of the Associate(s) will not be increased above the percentages indicated in the standard budget.

No more than £700 per Associate (£1,700 when the Knowledge Base Partner is not an HEI) may be used from the budget amount available for the Associate’s personal development (c. above) towards qualification registrations and examinations fees.

Funds can only be transferred between b, c and d. Any such proposed transfer should be reflected in the figures included in the above table and justified at 8.1 (Changes from the Standard Budget). Increases to the standard amounts for c. and d. can be proposed but these must be justified at Section 8.1 and may or may not result in an increase in the amount of grant offered.

8.1 Changes from the Standard Budget
Please state, and justify, any proposed changes from the standard amounts available. If transfer or additional funds are sought, you should discuss this with a KTP Adviser and state clearly what you are requesting and why. Where there is more than one Associate please make this clear within the text and provide separate estimates of cost for each. The justification should make clear what additional costs are being requested for each heading. These costs should be included in Section 8.0
Description / Estimate of
Total costs (£)
Directly Incurred Costs
Travel and subsistence -Academic.
Sub Total of Academic Travel
Travel and Subsistence –Associate
Sub Total of Associate Travel
Total Travel Requested
Less Standard Travel Budget
Additional Travel Budget Requested
Consumables
Total of anticipated expenditure
Less Standard Consumables Budget
Additional Consumables Budget Requested
Directly Allocated Costs
Knowledge Base Supervisor
Associate(s) Estate Costs
Mentoring Support
Indirect Costs
Additional Associate Support
Total of all the above Cost Headings
8.2 Additional company contributions
Please estimate the cost to the Company Partner over and above the contribution set out in column 3 at section 8 of participating in the proposed Knowledge Transfer Partnership. Briefly describe what these costs cover.
Description / Estimate of costs (£)
Associate salary ‘top-up’
Management supervision
Other staff costs (incl. training)
Materials
Capital equipment
Other costs
Total

1 of 22

Grant Application and Proposal Form (Always send forms as attachments)

Single Associate Project Part A

(Version 3.6 - October 2009)

[1]The term ‘Company’ includes Private Sector businesses, qualifying Public Sector organisations such as NHS Trusts and Third Sector organisations including charities

[2] This person should also sign the Joint Commitment Statement – Section 13.

[3] Each project stage should provide the reader with a general description/narrative of ‘how’ the work will be done and how it relates to project objectives and outputs, in sufficient detail to demonstrate an appropriate level of project planning. See guidance notes for further explanation.

[4] Outputs should relate to those listed in 2.4.

[5] Please add the date