Of a New Initiative for a Public Private Partnership with the Roadmaps of Topsector Chemistry

CONFIDENTIAL

(versie 09-09-2016)

Assessment of ‘fit’

of a new initiative for a public private partnership with the roadmaps of Topsector Chemistry

The assessment is done anonymously. Therefore:

·  give the data about the project leader and the participating compan(y/ies) on this first page. The TKI office will remove this page before sending the form to the Programme Council(s) who perform the assessment.

·  please take care not to mention the name of the project leader or the compan(y/ies) involved in the project on the next page.

Project leader / Principal Investigator - PI (from academia)
Name, first name, title(s) / male / female
University
Department / Section
Postal Address / Zip/city
Tel / Fax / Email
Position / Prof. / Associate Prof. (UHD)/ Assistant Prof. (UD)/ other :… / End date contract
Co-applicant (from a company or another non-academic organisation) (copy/paste as many times as needed)
Name, first name, title(s) / male / female
Company/
Organisation
Department / Section
Postal Address / Zip/city
Tel / Fax / Email
Position

Assessment of ‘fit’

of a new initiative for a public private partnership with the roadmaps of Topsector Chemistry

The assessment is done anonymously. Therefore, please take care not to mention the name of the project leader or the compan(y/ies) involved in the project on this page.

1. Project details

1a Title project proposal:

1b Relevant roadmap(s):

☐ Chemistry of Advanced Materials

☐ Chemistry of Life

☐ Chemical Conversion, Process Technology and Synthesis

☐ Chemical Nanotechnology

☐ Biobased Economy

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CONFIDENTIAL

2. Main source of public funding

2a What is or will be the main source of public funding?

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☐ NWO Innovation fund Chemistry (go to 2b)

☐ TNO

☐ Other TO2 institute, namely:……

☐ ‘TKI-toeslag’

☐ ‘Transitiegelden’ Topsector Chemistry

☐ Other, namely:…..

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2b If you want to submit a proposal to NWO Innovation Fund Chemistry, please indicate what type of financial support you request from NWO:

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☐ KIEM

☐ LIFT

☐ TA

☐ CHIPP

☐ Other, namely:

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Budget breakdown (estimation, in k€):

Private / Public / Total
In cash
In kind
Total

Scientific summary (max. 250 words):

Arguments for ‘fit’ by the main applicant (max. 250 words):

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