Peer Award Application Form

PEER AWARD APPLICATION FORM

For applications to the SRPe Pools Engagement in European Research (PEER) fund, please complete the application form below and submit itto Susan Hamilton, SRPe Project Manager, at .

The submission deadline is 5pm on Wednesday 31st January 2018.

Part 1 – Main Applicant Details

Institution Name
Applicant Name
Position
School/Department
Contact Address
Telephone
Email

Part 2 – Academic Partners (within SRPe)

Institution Name
Contact Name
Position
School/Department
Contact Address
Telephone
Email

For additionalpartners please add separate boxes.

Part 3 – Academic Partners (non-SRPe)

Institution Name
Contact Name
Position
School/Department
Contact Address
Telephone
Email

For additional partners please add separate boxes.

Part 5 – Details of theProposed PEER Activity

Activity Start Date
Activity End Date
PEER ActivityTitle
(SRPe will use this title for external communications & reporting)
Brief description of the PEER Activity
(Max 200 words.)
(Attach any relevant documents as Appendices)
Brief Description of Planned Outputs / Outcomes
(Max 200 words)
Related European Call / Project / Programme Title
(if already identified / applicable / relevant)
Brief Description of the European Project / Programme
(Max 200 words)
Which SRPe Strategic Theme(s) does the PEER Activity align with?
How will the participating universities and / or the wider SRPe pool benefit from the PEER Activity?
(Max 200 words)
How will the participating industrial partners benefit from the PEER Activity?
(Max 200 words)
What do you anticipate will be the wider impact of the PEER Activity?
(Max 100 words)
What further steps, if any, do you anticipate taking following on from the PEER Activity?
(Max 200 words)
Any additional comments to support your application?
(Max 100 words)

Part 6 – Delivery Plan

List all sub-activities and deadlines.

The deliverables should include an End of Activity Report, which must be submitted no later than 31stAugust 2018.

# / Sub-Activities / Deadline
1.
2.
3.
4.
5.

Part 7 – Costs

Please provide a detailed breakdown of the estimated costs (in GBP) of the activity below:

Staff Costs

List all the individuals (for all SRPe university partners) who will be working on this project, together with the number of planned hours and overall day rate (direct salary + NI + pension). The day rates should be normal university partner rates. Note that the maximum eligible day rate is £500 pd.

Name / Position/Institution / No. Hours / Day Rate (£)

OtherCosts

List below all of the non-staff costs (such as travel, subsistence and meeting costs) indicating whether they will be incurred by an SRPe University, or another organisation in the consortium. Please note travel and subsistence costs for non-academic partners is ineligible.

Item or activity / SRPe University (£) / Non-SRPe University (£) / Industry Partner (£) / Total per activity (£)
Sub-Total (£)

Total Funding Requested

Total funding requested from SRPe under this PEER Activity application (staff costs and other costs).

Total amount requested from SRPe (£)

Part 8 - Data Protection

SRPe will use information provided on the application form for the purpose of processing the application to assess its suitability for support. If the application is successful, SRPe will use the information for administration and management purposes, including carrying out appropriate checks, audits and marketing.

Part 9 - Applicant Signature

Please ensure the application form is signed by an authorised institutional approver before submission. Applications submitted without institutional sign off will not be eligible for funding.

Institutional Approval
Institution Name
Approver Name
Job Title
Signature
Date
Applicant Signature
Date

PEER & PECRE Equality and Diversity Monitoring Form

The Scottish Research Partnership in Engineering is committed to ensuring that applicants and employees are not subject to direct or indirect discrimination based on protected characteristics of age; disability; gender reassignment; marriage and civil partnership; pregnancy and maternity; race; religion or belief; gender; and sexual orientation; or any other irrelevant factor.

We would be grateful if you would complete this form and return it with your application. The information will not be used as part of the selection process itself and will be held in compliance with The Data Protection Act 1998. The information contained in this form will be used solely for statistical purposes. Your co‐operation in completing and returning this form is appreciated.

Basic details / Response
Name
Institution
What is your age? / Response
16-24
25-34
35-44
45-54
55-64
65+
What is your gender? / Response
Male
Female
Other
Prefer not to say
Is your gender identity the same as the gender you were originally assigned at birth? / Response
Yes
No
If ‘No’, specify if you wish
Prefer not to say
Ethnic Origin: The options reflect the census ethnicity classifications used throughout the UK and allow comparative statistics to be derived both within and out with the sector. Tick the most appropriate box to indicate your ethnic origin.
White – British / White Scottish / White – Irish
Other White background / Asian or Asian British – Indian / Asian or Asian British – Bangladeshi
Asian or Asian British – Pakistani / Chinese / Other Asian background
Black or Black British – African / Black or Black British – Caribbean / Other Black background
Mixed – White and Black African / Mixed – White and Asian / Mixed–White and Black Caribbean
Other Mixed background / Not known / Prefer not to say
Other Not Listed Above
What religion, belief or faith do you belong to? / Response
None
Christian: Church of Scotland
Christian: Roman Catholic
Christian: Other Christian (please specify)
Muslim
Buddhist
Sikh
Jewish
Hindu
Humanist
Another religion or belief (please specify)
Prefer not to say
How would you describe your sexual orientation? / Response
Bisexual
Gay man
Gay woman / Lesbian
Heterosexual / straight
Not sure
Other (please specify)
Prefer not to say
What is your legal marital or same sex partnership status? / Response
Single
Married / Civil Partnership
Separated
Divorced / dissolved Civil Partnership
Co-habiting / in a relationship
Widowed / surviving partner from Civil Partnership
Prefer not to say
Parental Requirements Please select if you are:
On additional paternity leave / On adoption leave / On maternity leave
Pregnant / Prefer not to say / Not applicable
Do you have a disability? / Response
I have a disability
I have no disability
Prefer not to say

Thank you for taking the time to complete this form.