Application Form for Pump-Prime FundsPlease complete all sections; boxes are expandable. Please refer to guidance notes for details of eligibility and funding requirements Delete the text in italics.

1. PROJECT INFORMATIONProject title

Project Duration Project duration may be from 3 to 6 months.

Project summary (maximum half a side of A4)

2. APPLICANT DETAILSPrincipal investigator:

Name

Position held

Organisation

Address

E-mail

Early Career Researcher? Yes/No

DAC-based? Yes/No + country of residence

UK-based? Yes/No BBSRC eligible? Yes/No

Co-investigator (if more than one Co-I, please add further sections below as required)Name

Position held

Organisation

Address

E-mail

Early Career Researcher? Yes/No

DAC-based? Yes/No + country of residence

UK-based? Yes/No BBSRC eligible? Yes/No

Early Career Researcher(s) (maximum 1 side of A4)

Industrial partner(s) (maximum half a side of A4)Industrial partners cannot be co-investigators on CONNECTED Pump Prime Funding applications. Please provide the name and details of any industrial partners in this section. Please refer to the Guidance Notes.

Partnership (maximum half a side of A4)

3. STRATEGIC RELEVANCEResearch priority area (please tick where appropriate)

Control strategies

Vector biology

New diseases Vector/virus interactions

Diagnostics/surveillance/ forecasting

4. ODA COMPLIANCE (maximum 1 side of A4)Answer questions 1, 2, and 3 as set out in the guidance notes.

5. CASE FOR SUPPORT (maximum 3 sides of A4)Please refer to the guidance notes for content to include under the headings below – please do not alter these headings. Do not attach any additional materials or include URLs – they will not be reviewed.

Background:

Programme and methodology:

References:

6. JUSTIFICATION OF RESOURCES (maximum 1 side of A4)

7. PATHWAYS TO IMPACT (maximum 1 side of A4)

8. DATA MANAGEMENT PLAN (maximum half a side of A4)

9. DIAGRAMMATIC WORKPLAN (maximum 1 side of A4)

PLEASE SUBMIT THE DIAGRAMMATIC WORKPLAN AS A SEPARATE DOCUMENT ATTACHMENT.

10. ETHICAL AND SOCIAL CONSIDERATIONS (maximum half a side of A4)

Plant sample transfer

11. STAFF DEVELOPMENT (maximum half a side of A4)

12. FUTURE WORK (maximum half a side of A4)

13. PROJECT COSTS please complete based on UK or DACUK

100% FECUK

80% FECDAC 100%

Principal investigator

Item:

Directly Incurred Staff Costs

Directly Incurred Travel and Subsistence Costs

Directly Incurred Other Costs

(e.g. consumables - please specify)

Sub-total Directly Incurred

Directly Allocated Investigators

Directly Allocated Estates Costs

Directly Allocated Other Costs

Sub-total Directly Allocated

Indirect Costs

For DAC-based investigators, this calculated as 20% of total Directly Incurred costs.

International non-DAC-based investigators are not eligible to claim indirect costs.

Total Costs of Principal investigator

Total amount requested by Principal investigator

UK100% FEC

UK80% FEC

DAC 100%

Co-investigator (if more than 1 Co-I, please replicate this section as required)

Item:

Directly Incurred Staff Costs

Directly Incurred Travel and Subsistence Costs

Directly Incurred Other Costs

(e.g. consumables - please specify)

Sub-total Directly Incurred

Directly Allocated Investigators

Directly Allocated Estates Costs

Directly Allocated Other Costs

Sub-total Directly Allocated

Indirect Costs

For DAC-based investigators, this calculated as 20% of total Directly Incurred costs.

International non-DAC-based investigators are not eligible to claim indirect costs.

Total Costs of Co-investigator

Total amount requested by Co-investigator

TOTAL PROJECT COST FOR ALL PARTNERS (100% FEC)

TOTAL AMOUNT REQUESTED FOR ALL PARTNERS

CURRENCY RATE USED

DATE AND SOURCE OF EXCHANGE RATE

14. CHECKLIST Please read and tick to indicate the following:

I am a member of the CONNECTED Network and confirm that all Co-investigators are members

My case for support is attached (no more than 3 sides of A4)

My diagrammatic workplan is attached

Submitting institution: I have attached a letter of support from my institution confirming acceptance of the 80% FEC funding rate and my eligibility for BBSRC-funding

Principal investigator institution (if different from above): I have attached a letter of support from my institution confirming acceptance of the FEC funding rate

I understand that I will give a seminar during the life of the project

I understand that I must submit a final narrative report including poster, together with any additional confidential data/information, within 4 weeks of the project end date

I understand the invoice and expenditure statement for the whole project must be submitted within 3 months of the project end date. I do not need to provide receipts but receipts must be retained by all partners in case they are required for audit purposes

Submitting institution: I understand that I will be expected to undertake due diligence checks on any subcontractors or third parties who will receive funding from this project and that evidence of these checks be submitted to CONNECTED prior to commencement of the project

15. SIGNATURES

PRINCIPAL INVESTIGATOR

Printed name in capital letters:

Sign your name:

Date:

UK SUBMITTING INSTITUTION INVESTIGATOR

Printed name in capital letters:

Sign your name:

Date: