JTC 2012 Pre-proposal application form

E-Rare-2 Call for Proposals 2012 for

"European Research Projects on Rare Diseases driven by Young Investigators"

Pre-proposal application form

1.a Project Title:

1.b Project acronym:

2. Project partner consortium coordinator:

Project coordinator Family Name, first Name
Institution/Department
Department
Position
Address
Zip code, City Country
Phone + Fax
E-mail address
Type of entity / Academia, Clinical or Public Health, SME and Industry
Type of entity (public/private-for-profit/private-non-for-profit)

3. Research Partners:

No. / Zip code, City, Country / Research Partner (principal investigator) / Institution, Department, full affiliations (address, phone + fax) / Email address / Type of entity Academia, Clinical or Public Health, SME and Industry / Type of entity (public/private-for-profit/private-non-for-profit)
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2
3
4
5
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4. Duration of the project (months):

5. Total funding applied for:€

6. Keywords

Identify between three and seven keywords that represent the scientific content.

7. Abstract (max. 1600 characters including spaces)

8. Summary of the project (once converted into Pdf document: max. 5 pages DIN-A4, Arial 11, single-spaced, margins of 1.27 cm)-

Description of the working programme including the objectives, the rationale, the methodology highlighting the novelty, originality and feasibility as well as the added value of the collaboration

9. Diagrams of the work plan, timeline, work flow and interconnections of work packages (Gantt chart, Pert or similar, max. 1 page).

10. In addition, two more pages can be added to the pre-proposal (please note that this is optional):

  • a list of references (max. 1 page)
  • a page of diagrams, figures, etc. to support the work plan description (max. 1 page)

11.Budget table (see last page for template)

12.CV for each applicant(max. 3 pages) and representative publication list of each participating principal investigator:

  1. Personal information (date of birth, address and laboratory web site)
  2. Main areas of research
  3. Description of academic career (date of PhD/MD or equivalent and name of PhD supervisor obligatory) and positions held to date (with brief description of reasons for any career breaks)
  4. Highest academicprizes/recognition received (no more than 5) in each of the following categories: most important invitations to present at scientific conferences; most important academic prizes/awards received; most important peer review activities, editorships and/or memberships in academic organizations (where applicable)
  5. Most important research projects funded in the past (no more than 5) (where applicable)
  6. Name and institution of key international cooperation partners in the last 5 years (where applicable)

Separate publication list:

- List of all scientific publications with 5-10 most important scientific publications outlined

The CV of all principle investigators (including the coordinator) should demonstrate compliance with the requirements given by the definition of “young investigator” (= 2-10 years between finish of PhD/MD or equivalent and pre-proposal submission deadline of the E.Rare-2 JTC 2012) in the call text.

All the information requested in this document must be compiled into one single Pdf-document and uploaded to the electronic submission system.In addition, please note that the information given in sections 1-7, 11 and additional information regarding the classification of the disease area and type of study will need to be entered again in the electronic submission system forms. There you can also enter potential experts suited and not suited for the evaluation of your proposal.

13. Date and signature of the coordinator

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JTC 2012 Pre-proposal application form

11. Budget plan of the project

Acronym:
No. / Project coordinator / Partner 2 / Partner 3 / Partner 4 / Partner 5 / Partner 6
Name (principal investigator)
Country
Funding organization
Personnel €
Consumables €
Equipment €
Travel €1
Other direct costs €2
Overheads €3
Total requested budget €
1Travel expenses should include the participation to intermediate and final status symposia which will be organized by the Joint Call Secretariat
2e.g. subcontracting, provisions, licensing fees; may not be eligible costs in all countries (will be handled according national regulations)
3 Overhead costsand eligible expenses: funding according to national legal framework and funding body regulations
Applicants are encouraged to confirm their eligibility with their national contact points

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