Innovation Awards for Franco-Chinese Teams 2016 Edition

ANNEX 2 APPLICATION FORM

(English version)

Innovation Awards for Franco-Chinese Teams 2016 Edition

Summary of items to be submitted(please tick the box to confirm that you have submitted the items):

A. Executive Summary and description of the Project and itscharacteristics

B. Detailed description of theProject

C. Economic Viability of theProject

D. Usefulness of the project in social, economic, industrial and environmentalterms

E. Commitment form for Teams and Teammembers

F. Authorization form for the communication and publication ofinformation

G. Team overview and structure, highlighting the team's Franco-Chinese bi-culturalaspect

Annex: Detailed CV of Team members(optional)

A.Executive Summary and description of theproject

(1/2 page of A4 in Word format, Arial 1)

NON-CONFIDENTIAL DESCRIPTION OF THE INNOVATION (RESEARCH PROJECT, PRODUCT, SERVICE, PROCESS, IDEA, SOFTWARE, BUSINESS MODEL, ORGANIZATIONALMETHOD…)

......

B.Detailed description of the project (Innovativeaspects)

(maximum of 2 pages of A4 in Word format, Arial 11)

You may also describe your Project in a one-minute video (Smartphone quality)

......

INNOVATIVE ASPECTS OF THE INNOVATION YOU HAVE IMPLEMENTED (TECHNICAL FEASIBILITY) (maximum of 1/2 page of A4 in Word format, Arial11)

Technological innovation: Non-technological innovation:

Comments, if any:

......

INDUSTRIAL PROPERTY MANAGEMENT (title, geographical scope, technological monitoring, value such as licenses, etc), if applicable (1/2 page of A4 in Word format, Arial11).

......

BENCHMARKING WITH COMPETITIVE EXISTINGINNOVATION

(maximum of 1/2 page of A4 in Word format, Arial 11)

......

PREVIOUS AWARDS AND DISTINCTIONS GRANTED FOR THE PROJECT PRESENTED FOR THE INNOVATION AWARDS FOR FRANCO-CHINESE TEAMS (maximum of 1/2 page of A4 in Word format, Arial11)

......

C.Economic viability of theProject

(maximum of 2 pages of A4 in Word format, Arial 11)

TARGETED APPLICATIONS (1/2 page of A4 in Word format, Arial11)

......

EXISTING OR FUTURE PARTNERSHIPS TO DEVELOP THE PROJECT (PUBLIC LABORATORIES, TECHNICAL CENTERS, COMPANIES, ETC.) – (maximum of 1/2 page of A4 in Word format, Arial11)

......

FOR R&D AWARD

PLANNED EXPENDITURE ESTIMATES UNTIL THE INNOVATION'S MARKETING STAGE – (maximum of 1 page of A4 in Word format, Arial11)

......

FOR R&D AWARDS

STUDIES TO BE CARRIED OUT (TECHNOLOGICAL, MARKETING, FINANCIAL, LEGAL, ETC.) (1/2 page of A4 in Word format, Arial11)

......

FOR INNOVATIVE PRODUCT AWARD

ADDITIONAL TRAINING TO BE PROVIDED TO TEAM MEMBERS (IF APPLICABLE) (1/2 page of A4 in Word format, Arial11)

......

FOR INNOVATIVE PRODUCT AWARD

R&DEXPENSES

R&D BUDGET AS A PERCENTAGE OF TURNOVER (WORLDWIDE AND CHINA)

(1/2 page of A4 in Word format, Arial 11)

......

FOR INNOVATIVE PRODUCTS AWARD

PROPORTION OF TURNOVER GENERATED BY THE NEW PRODUCT SINCE BEING MARKETED (1/2 page of A4 in Word format, Arial11)

......

D.Usefulness of theproject

(in social, economic, industrial and environmental terms)

(maximum of 2 pages of A4 in Word format, Arial 11)

USEFULNESS OF THE PROJECT IN ENVIRONMENTIAL TERMS (1/2 page of A4 in Word format, Arial 11). Taking into account the entire life cycle, consumption and emissions, strengths and weaknesses, give elements with precisefigures.

Please answer the following questions if applicable:

1.Calculation of economic profit in terms of reducing greenhouse gas emissions or reduction of energyconsumption

2.Absence of impact of the innovation (in technological or non-technological terms) o the targeted environmental benefit – give elements to argue theanswer.

3.Evidence with precise figures, illustrating the stakes in the fight against climate change corresponding to the diffusion ofinnovation

......

E.Commitment form for Teams and Teammembers

I, the undersigned ......

(Surname and forenames,......

Date and place of birth) ......

Residing at ......

(Full mailing address)

......

RepresentingtheTeam[Name ofTeam]

am a candidate for the

R&DAward

Innovative ProductAward

Innovative Initiative Award of Franco-ChineseTeams

and agree to abide by all clauses in the Terms and Conditions of the Innovation Awards for Franco-Chinese Teams.

Done in ...... on ...... 2017

F.Authorization form for the communication and publication ofinformation

One form for each Team member must be completed, signed and returned with the application form

I, the undersigned ......

(Surname and forenames,......

Date and place of birth) ......

Residing at ......

(Full mailing address)

......

Memberof Team[Name ofTeam]

am a candidate for the

R&DAward

Innovative ProductAward

Innovative Initiative Award of Franco-ChineseTeams

and authorize the Organizing Institution to publish all contacts, information and a non-confidential Project description, as indicated on my Team's application form, in any advertising media as part of the Innovation Awards for Franco-Chinese Teams.

Done in ...... on ...... 2017

G.Team overview andstructure

Highlighting the team's Franco-Chinese bi-cultural aspect

Name of the Team:......

Structure that the Team is part of

Type of structure

......

Size of structure

......

Number of employees/researchers/students

Worldwide ......

China......

Turnover

Worldwide......

China......

Motivations and personal commitments of the Team and Team members

(Signature required)

Annex: detailed CVs of Team members (optional) (maximum of 1 page per CV)

Names and identities of team members as well as professional experience and skills that the Team and Team members possess

You are:

1.The Team's Frenchrepresentative

Surname: ...... Forename(s)…...... Date and place of birth: ...... Sex: F _ M _

Nationality: ......

Home address:......

Telephone No.: ...... Mobile No.: ......

Email: ......

Or,

2.The Team's Chineserepresentative

Surname: ...... Forename(s)…...... Date and place of birth: ...... Sex: F _ M _

Nationality: ......

Home address:......

Telephone No.: ...... Mobile No.: ......

Email: ......

You are:

Astudent

Employed

If you are employed, please specify:

Your current company: ......

Your position within the company:......

Education level:

_ BAC _ BTS/DUT

_ Licence 1 _ Licence 2 _ Licence 3

_ Masters 1 _ Masters 2 _ Doctorate

_ Engineer _ Other (specify):…………......

3.Composition of theTeam

Please indicate for each member of the Team:

French members:

Surname:Forename(s):Age:Sex:F_M_Education:

(Reproduce the table as many times as there are French team members)

Chinese members:

Surname:Forename(s):Age:Sex:F_M_Education:

(Reproduce the table as many times as there are Chinese team members)

Members of another nationality (if applicable)

Surname:Forename(s):Age:Sex:F_M_Education:

(Reproduce the table as many times as there are team members of another nationality)