CRDC



217092883717005366385124460Office Use Only:00Office Use Only:Scholarship Application 2019/20Part 1- General Details Organisation ID : CRDC ID:Project Title:(max 80 char)Supporting CRDC Project(if applicable) Degree Sought PhD /Masters Institution of StudyType of ResearchChoose an item.Scholarship Commencement Date:Click here to enter a date.Scholarship Completion Date:Click here to enter a date.CRDC Outputs (%)Economic: Environmental:Social:Please refer to CRDC’s Strategic R&D Plan 2018-2023 for the following.CRDC Goal:Click here to select a GoalCRDC Key Focus Area:Click here to select a KFACRDC Outcome:Click here to select a OutcomePlease identify the relevant Measure of Success as outlined in the CRDC Strategic R&D Plan.CRDC Measure of Success:Strategic Research Priorities:Choose a PriorityRural R&D PrioritiesChoose a PriorityPart 2- Contact DetailsScholarship Administrator (Host organisation) Details:Title:First Name:Surname:Organisation:Phone:Mailing Address:Fax:Mobile:Email Address:Applicant Details:Title:First Name:Surname:Organisation:Phone:Mailing Address:Fax:Mobile:Email Address:Supervisor (Host Organisation) (Senior Scientist overseeing the project):Title:First Name:Surname:Organisation:Phone:Mailing Address:Fax:Mobile:Email Address:Additional Supervisor:Title:First Name:Surname:Organisation:Phone:Mailing Address:Fax:Mobile:Email Address:I/We confirm that we are authorised to lodge this application on behalf of the proponent organisations.SIGNATURE OF ORGANISATION’S REPRESENTATIVE:DATE:Part 3 – Detailed Project Proposal3.1 Plain English Summary (Hint: Summary to be limited to half A4 page in size, a font greater than 11 & max 4,000 characters including spaces)3.2 List the main project aims (in bullet point)3.3 Demonstrate that this project is original research3.4 Identify and explain the significance of the research to the end users (ie those who will use the knowledge and/or products of the research) (max 200 words)3.5 Provide detail of the project proposal including Background, Methodology, Outcomes/Outputs (max 2 pages)Detailed Project Proposal (continued)3.6 Annual Milestones and KPI’s (Tasks) (Hint: For every Objective there must be AT LEAST one corresponding Milestone AND one Performance Indicator. Milestone dates must be between 1/7/19 and 30/6/22 ie max 3 year contractual period)MS No.Milestone Description(what are the key steps in answering the question)Performance Indicator(one Output per Milestone)Expected science/industry outcome(one S/I Outcome per Milestone)Start Date(dd/mm/yy)Finish Date(dd/mm/yy)Risk Analysis of Not Achieving Objective(low/med/high)Research question1.11.21.3Research question2.12.22.3Research question3.13.23.3Research question4.14.24.3Research question5.15.2Part 4 – Referees(NB: Please provide written references from each referee)Referee 1: FORMTEXT (Name & title of referee)Organisation: FORMTEXT ?????Postal Address: FORMTEXT ?????Ph: FORMTEXT ????? FORMTEXT Fax: FORMTEXT ????? FORMTEXT E-mail: FORMTEXT ????? FORMTEXT Referee 2: FORMTEXT (Name & title of referee)Organisation: FORMTEXT ?????Postal Address: FORMTEXT ?????Ph: FORMTEXT ????? FORMTEXT Fax: FORMTEXT ????? FORMTEXT E-mail: FORMTEXT ????? FORMTEXT Part 5 – Scholar Details(NB: Please provide a copy of your academic record)Present Position: FORMTEXT ?????Undergraduate record: FORMTEXT ?????University attended: FORMTEXT ?????Faculty: FORMTEXT ?????Degree obtained or being undertaken: FORMTEXT ?????Honours: FORMTEXT ?????Date of graduation: FORMTEXT ?????Other Postgraduate Training (Postgraduate Applicants only): FORMTEXT ?????Research Papers: FORMTEXT ?????Employment History:Period of EmploymentPositionOrganisationExperience Gained FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ?????Future Employment (All Applicants) i.e. Where does the applicant envisage they would be employed in the future and in what role:? FORMTEXT ?????Part 6 – Scholarship Funding DetailsCRDC offers Top Up postgraduate scholarships of $10,000 p.a. for 3 years. Applicants must expect to receive a Research Training Program (or equivalent) scholarship commencing in 2019/20.(a) Has the Scholar applied for or received an Australian Postgraduate Scholarship (APA) or a University Scholarship? FORMTEXT ?????(b) Funding requested from CRDC (Please provide detailed justification of the funding request using the budget excel spreadsheet). FORMTEXT ?????(c) Funding from Other Sources: Have you applied to other funding bodies with this proposal? Please list and indicate response: - Unknown (when will you know?); Rejected; or Supported (please give details). FORMTEXT ?????Part 7 - Intellectual Property & Commercialisation 7.1 IP to be brought to the projectWill Background or Third Party IP be used for this project? (Double click box to check Yes or No) FORMCHECKBOX Yes FORMCHECKBOX NoPrior Project CodeIP CategoryNature of IPConditions of UseFreedom to Operate?Confidentiality RestrictionsHow IP will contribute to ProjectDetailed DescriptionIP OwnerProvide details if NOT “Public Domain free to use”Provide details belowProvide details if NOT “Free dissemination”Risks IdentifiedExample:-1 CRDC1101ReportCopyrightResearch AgreementYes (no restrictions)Free DisseminationCRDCNone1Choose an item.Choose an item.Choose an item.Choose an item.Choose an item.2Choose an item.Choose an item.Choose an item.Choose an item.Choose an item.3Choose an item.Choose an item.Choose an item.Choose an item.Choose an item.4Choose an item.Choose an item.Choose an item.Choose an item.Choose an item.What technical knowledge (ie “know how”) will be brought to the project? Provide a description including the owner of this knowledge.(eg 1 – Insect Ecology Project: - Knowledge & expertise in insect ecology by the researcher; 2 – Technical expertise in product development: - Formulation expertise to be provided by a collaborating company)Intellectual Property & Commercialisation (continued)7.2 Potential IP to be created in the projectProject CodeIP CategoryNature of IPConditions of UseFreedom to Operate?Confidentiality RestrictionsRisks IdentifiedDetailed DescriptionIP OwnerProvide details if NOT “Public Domain free to use”Provide details belowProvide details if NOT “Free dissemination”Example:-1OtherExclusive LicenceResearch AgreementResearch purposes onlyRestrictions to publicationMTA restricts use of outcomes.Pest population statistical modelCRDC and xyz UniversitySubject to terms of Research Agreement.Subject to terms of Materials Transfer Agreement (MTA)Subject to terms of MTA.1Choose an item.Choose an item.Choose an item.Choose an item.Choose an item.2Choose an item.Choose an item.Choose an item.Choose an item.Choose an item.3Choose an item.Choose an item.Choose an item.Choose an item.Choose an item.4Choose an item.Choose an item.Choose an item.Choose an item.Choose an item.5Choose an item.Choose an item.Choose an item.Choose an item.Choose an item.Intellectual Property & Commercialisation (continued)7.3 Adoption Pathway/Commercialisation Potential (max 2,000 character limit including spaces for each question)i) Describe the potential outcome of the research project to be commercialised (ie product/process)ii) What is the products/process’ commercialisation potential eg low, med or high? Please explain. (If low, go to Budget excel template)iii) Identify market(s), size and potential market share for the product/process.iv) Describe your plan for release into the market.v) Identify any commercial partners to be involved with the release, and the benefits associated with their involvement.vi) Are there any potential issues or risks arising from commercialising the product/process?NEXT STEP - PLEASE GO TO THE SEPARATE BUDGET TEMPLATE (EXCEL FILE) TO ENTER THE FINANCIALS.Once completed, please email both the Word Scholarship application template AND the Excel Budget template to research@.au ................
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