Equipment Yes No

UNIVERSITY OF NAIROBI
OFFICE OF THE DEPUTY VICE-CHANCELLOR
(RESEARCH, PRODUCTION & EXTENSION)
DEANSCOMMITTEE RESEARCH GRANT (DCRG)
TOP-UP APPLICATION FORM
2015 – 2016
APPLICATION DEADLINE: JULY 31, 2015
*EXPAND THE SPACES PROVIDED TO FIT. RECOMMENDED FONT: NEW TIMES ROMAN 12
*IF HANDWRITING THE APPLICATION, ENSURE YOU FIRST EXPAND THE FILL-IN SPACES TO ACCOMMODATE REQUIRED INFORMATION
*FOR EASE IN NAVIGATING THE FILLABLE FIELDS, USE THE TAB KEY
PART I: APPLICANTS DETAILS
1.a) TITLE (Tick as applicable) / Prof/Dr./Mr./Mrs./Ms.
1.b) NAME (surname first)
1.c) DESIGNATION:
2. a) EMPLOYMENT STATUS (Tick as applicable) / Permanent/Temporary
2. b) SCHOOL /INSTITUTE /DEPARTMENT /CENTRE:
2.c) Degree programme and expected year of completion (applicable only to PhD students)
2.d) COLLEGE:
3) EMAIL ADDRESS:
4)TELEPHONE CONTACTS:
5) ADDRESS:
6)PROVIDE DETAILS OF OTHER INVESTIGATORS (If any)
PART II: RESEARCH DETAILS
7)RESEARCH TOPIC:
8. a) ARE THERE ANY CHANGES TO THE PREVIOUS RESEARCH OBJECTIVES? (tick as applicable) / Yes No
8.b) IF YES, STATE THE REVISED CHANGES:
9)PROVIDE A PROGRESS REPORT ON YOUR RESEARCH
10)PROVIDE DETAILED WORK FOR THE REMAINING RESEARCH WORK
11)STATE THE TOTAL COST OF THE RESEARCH PROJECT (Indicate amount in Ksh.)
12) PROVIDE AN ITEMIZED BUDGET FOR THE REMAINING RESEARCH WORK (the budget should include dissemination of outputs component. Also include evidence of having accounted for previous awards)
13.IS THIS YOUR 1ST, 2ND OR FINAL TOP-UP?
14. HOW MUCH TOP-UP ARE YOU REQUESTING FROM THE DEANS RESEARCH GRANT? (Indicate in Ksh.)
15.a) HAVE YOU RECEIVED ANY FUNDING FOR THIS RESEARCH PROJECT FROM ANY OTHER SOURCE(S)? Yes No
15.b) IF YES, INDICATE HOW MUCH YOU RECEIVED AND FROM WHERE
16. a) DISSEMINATION OF OUTPUTS FORMS AN IMPORT PART OF ANY RESEARCH. HOW DO YOU PLAN TO CARRY THIS OUT?
16. b) HOW MUCH HAVE YOU BUDGETED FOR THIS EXERCISE?
17) HAVE YOU SIGNED THE UNIVERSITY OF NAIROBI INTELLECTUAL PROPERTY POLICY ACCEPTANCE AGREEMENT
Yes No
(If no, download, fill and attach the Intellectual Property Policy Acceptance Agreement upon submission of this application)
DECLARATION
I declare that I am familiar with the rules and regulations of this Grant and undertake to abide by them.
Applicants’ signature:
Date:
PART III: ENDORSEMENT BY THE DEPARMENT (to be completed by the HOD)
1)WHAT ARE YOU COMMENTS ON THE PROGESS OF THIS RESEARCH PROJECT?
2. a) HAVE YOU EXAMINED THE BUDGET? Yes No
2. b) IF YES, WHAT ARE YOUR COMMENTS?
3) IS THE DEPARTMENT IN A POSITION TO SUPPORT THIS PROJECT WITHRESPECT TO THE FOLLOWING?

Equipment Yes No

Instruments Yes No

Consumable Items Yes No

Any other (please state)
Forwarded by the Head of Department/Institute/School
NAME
SIGNATURE
DATE

Endorsed by:

Dean/Director, School/Faculty of ______

______

SignatureDate

Principal, College of ______

______

SignatureDate