STDF
Technology Incubator Program
(STDF-TIP)
Science and Technology Development Fund
Application Form
OPEN CALL
- Personal Information
الاسم ثلاثي (بالعربي):
Name (En):
National ID
City
Address
Phone/Mobile
Fax
Affiliation
Position
Academic Qualification
Industrial Experience
Entrepreneurial Experience
Research & Development Experience
Business Experience
- Project Information
Title
Required Budget (Detailed table below)
Duration (Gantt Chart below)
English summary: should describe the proposed applied research, objectives, methodology, expected outcomes and economic and social impact, if any (One page maximum)
Arabic Summary: is an understandable translation of the English summary (One page maximum)
Technology description and applications: Describe briefly the technology you are going to apply in the project (figures are encouraged if applicable). Indicate if the application represents a brand new technology, new application of existing technology, or imitation/modification of an existing technology. Indicate the applications, benefits and impact of the applied technology to the subject area, and to the society in general (Three pages maximum)
State-of-the-Art: Describe the state-of-the-art in the project subject area (existing products, patents, publications, ...). Also, describe any previous achievements or pilot studies which have been conducted by you (your team) within the project subject area. It is worth to mention your relevant international publications, patents, former research grants and applied experience in the project subject area in this section of the proposal (Two pages maximum)
Objectives: Briefly and succinctly states your project’s main and specific objectives (One page maximum)
Approach and methodology: Briefly describe how your project will be implemented, including your general approach, activities, methods, and project inputs. Specify the methods only to the extent needed to give a general idea of the work to be done and the findings it will yield (Four pages maximum)
Society/Market need and stakeholders: Describe the national society/market need for the applied technology. Indicate the general and specific key stakeholders in the technology, and if there is already potential interest in or investment opportunity for the technology (Two pages maximum)
Project outcomes and impact: List the expected project outputs (typically tangible products, prototype(s), applied solutions and societal/economical impact). Avoid general benefits and focus on specific, measurable benefits only (One page maximum)
Hardware and Software tools required
Do you have a working plan?
Will you agree to comply with all applicable regulations and Ordinances if you are accepted to the Incubator Program?
Describe the stage of development your technology is in at this time
Does your technology have special facility needs? (High voltage, refrigeration, special security, etc)?
State your reason(s) for seeking STDF Incubator Program
Do you currently have feasibility study
Check areas of assistance requested from STDF Technology Incubation Program (TIP)
Concept testing / □
Technological activities and support / □
IPR support / □
Licensing and contracting services / □
Seed funding / □
Basic management services / □
Prototyping and market testing / □
Administrative assistants / □
Consultation / □
Entrepreneur capacity building / □
Virtual hosting within industries / □
Access to venture capital and industrial network / □
Coaching / □
Key references: List recent and relevant literature and patents cited in the proposal (One page maximum)
Applicant hereby certifies that to the best of his/her knowledge that all the information stated on this application and attached to it, is true and accurate. Applicant understands that STDF will retain this application and any attached materials whether or not it is approved.
Signature:
Date:
Budget Format
Eligible costs / Break downs / STDF support
(L.E.) / Non STDF support
(L.E.) / Total project Costs
(L.E.)
(A) Incentives
(Incentive/month) multiplied by number of months. Please indicate the % of time spent on the project / PI
Team
Technicians and/or Labor
Consultation fees
Total Incentives
(B) Equipment / Equipment
Spare parts
Total Equipment
(C) Expendable Supplies & Materials / Stationary
Miscellaneous Laboratory, Field supplies, Materials, …etc.
Total expendable Supplies & Materials
(D) Travel (according to governmental rules) / Transportation
Accommodation
Total travel
(E) Other Direct Costs / Services / Manufacture of specimens & prototypes
Acquiring access to specialized reference sources databases or computer software
Fees for use of facilities in other national institutions (incubation fee)
Computer services
Report preparation
Training
Publications & patent Costs
Workshops organization
Others
Total other direct costs
(F) Total Direct Costs
(G) Total Direct Costs less Equipment
(H) Overhead (10% of G)
(I) TOTAL COST (F + H)
Gantt chart
Task No. / Task Title / Start Date / End Date / Duration (Months) / 1st Year / 2nd Year / 3rd Year / Expected measurable outcomes of successful implementation of the task
M3 / M6 / M9 / M 12 / M 15 / M 18 / M21 / M 24 / M 27 / M 30 / M 33 / M 36
Dates of semi-annual progress reports
- Evaluation Process
STDF Technology Incubation Program (STDF-TIP)
Evaluation Form-Technical
Applicant name: / Current position:Title of the project:
Project ID: / Field:
Project Budget: / Project Duration:
Item / Points / Score
- Is the proposal (innovation) represents: New technology (6) OR New application (4) OR Imitation (2)?
- Is the innovation patented (8) or submitted (4) or Unpatented (2)
- Scientific merit of the proposal
- Project team qualifications and related experience to the project topic
- Is the submitted design of prototype acceptable and can be manufactured? Acceptable and can be manufactured(4), Needs redesign (2), or cannot be manufactured (0)
- Is the proposed budget and duration suitable for manufacturing of the prototype and/or implementation of the pilot experiment? Reasonable (4), Under or overestimated (2), or Unreasonable (0)
- Is the proposal (innovation) represents a top priority and help in solving of stressing and pressing problems facing the society?
- Your overall justified opinion
Total / 50
* Please note that the score is out of 50%, the other 30% is for the commercial evaluation and 20% for STDF panels
Reviewers' solid and concise justification for acceptance or rejection (Use additional blank sheet if necessary)
Reviewer Name and Signature / Affiliation / DateSTDF Technology Incubation Program (STDF-TIP)
Evaluation Form-Commercial Panel (oral presentation)
Applicant name: / Current position:Title of the project:
Project ID: / Field:
Project Budget: / Project Duration:
Item / Points / Score
- Is there a compelling market need for the innovation?
- Is the applicant aware with the state-of- art in the field of his/her innovation?
- Are proposed Budget and Duration reasonable?
- Is the application/product has a competitive advantage?
- Availability of stakeholders (potentially) willing to invest/utilize this application/product (government or private sector)
- Societal/economical impact of the application/product
- Project team has a clear solution/implementation plan of the solution/Ease of implementation
- Possibility of achieving objectives with success/Team consideration of the involved risks in the project (Market related – Political – Regulations – etc.)
Total / 30
* Please note that the score is out of 30%, the other 50% is for the technical evaluation and 20% for STDF panel.
Reviewers' solid and concise justification for acceptance or rejection (Use additional blank sheet if necessary)
Reviewer Name and Signature / Affiliation / DatePage 1 of 8