Form FS01 by 2Alffe

VIEWS: 5 PAGES: 17

									                                                                                                              1
Form FS01
                               Frontier Science Research Proposal
                                     尖端科學研究詳細計畫申請書
1. General Information                                           Application Number:


                     Chinese
Title of Proposal
                     English

Research Field                 Life Sciences       生物處         尖端研究計畫

               English Name                                       Chinese Name
Principal
Investigator                                                        身份證字號
                  Position
                                                                       (I.D. Code)

Institution & Department
                                  From              2013/8/1      to       2018/7/31
Project Entire Period
                                           Year / month / date             Year / month / date

Type of Research               Basic Research       Applied Research          Technological Development

Does this research project involve the following? (Check and attach relevant consent forms, if applicable.)
     Human Studies Gene Recombination Animal Studies


                           Name:___________________(Chinese)___________________(English)
                           Mailing Address in Chinese: ______________________________________
Corresponding Person
                           Telephone: (Office)                   (Home)                          (Mobile)
                           Fax:                                  E-mail:


Principal Investigators’ Affidavit:
The research proposed in this grant application has not been financially supported by any funding agency. I
am aware that any withholding, falsification, or misrepresentation of information could result in administrative
actions such as the dismissal of an application or the suspension and /or termination of an award, as well as
other possible punitive actions.


Signatures -- Principal Investigator(PI):                                            Date:


                 Co-PI of the Project, if any:




                                                                                                              1
                                                                                             2
Form FS02



                                     2. Check List
                                                                                    check/Page


1) General Information (Form FS01) …………..……………….………….…..…....                       □- 1

2) Check List (Form FS02) …..……………….………….…..……….…....……......                       □- 2

3) Requested Budget for Entire Term of Project Period (Form FS03)………….……            □- 3

4) Key Research Staff (Form FS04)……………………………………....….............                   □-

5) Personnel Expenses (Form FS05)………………………….……………………...                             □-

6) Consumable Expenses (Form FS06)………….…….………………….………….                             □-

7) Equipment Expenses (Form FS07)……………………….…….………………....                            □-

8) Large Equipment Center Charge (Form FS08)…….….…….…...…….….……....                 □-

9) Travel Expenses for Mainland China and International Destinations (Form FS9)     □-

10) 補助學者專家赴大陸地區從事短期科技研究申請書(Form FS10)….………..                                        □-

11) Travel Expenses for International Conferences (Form FS11)…………….………              □-

12) Previous and Current Research Projects and Submitted Proposals (Form FS12) ..   □-

13) Keywords and Abstracts (Chinese and English) (Form FS13)……..….……….....          □-

14) 中文摘要及關鍵詞(Form FS14) ………….…….………………….…………...                                     □-

15) Contents of Research Proposal (Form FS15)…………..………………………....                    □-

16) 行政院國家科學委員會個人資料表(Form FS16)…………..…..…..........…......... □-
17) Curriculum Vitae (Form FS17)…………….………………………..…..…..…........ □-
18) Reprints of within 5 papers……………………………………..…..….…................ □-
Remarks:
1) Use Times New Roman font, 12-point type, and single-spacing.
2) Page limit for Contents of Research Proposal(except CV) is 50 pages.
3) Proposal that do not meet these format requirements mentioned will
   automatically be rejected.




                                                                                             2
                                                                                                                            3
Form FS03
3. Budget Request for Entire Term of Project Period:

                                                                      Currency unit: NTD Thousands (1 USD  32 NTD)
                                                                                                                  Total
            Project Year
                              1st Year           2nd Year          3rd Year      4th Year                      for Entire
                year/month                                                                       5th Year
                             201 / -201 /        201/ -201 /      201 / -201 /   201 / -201 /   201 / -201 /    Term of
Budget Categories                                                                                               Project
                                                                                                                 Period
Personnel


Consumables


Equipment

Travel Expenses for
Mainland China
and International
Destinations

Travel Expenses for
International Conferences


Overhead


Total for Each Year


   Large Equipment
Center Charge

Support from the PI’s institution or other organizations (including industrial support).
Leave space blank if not applicable.
                                            Items Funded
  Supporting Institutions                                                Amount of Funding              Funding Period
                                   (personnel, equipment, etc.)




 Signature of the administrator of PI’s department:__________________________
 (or attach other evidence of support)




                                                                                                                            3
                                                                                                                         4
Form FS04

4. Key Research Staff:
   1) Indicate staff type in the following order: principal investigator (PI), collaborating principal investigator
      (co-PI), assistant investigator#, postdoctoral research fellow, and visiting personnel.
   2) Fill in name, institution/department, position, role in project, and percent of effort for each person on
      the projects.


                        Name
                                          Institution/                                                Percent of
       Staff Type    (In Chinese                             Position        Role in Project
                                          Department                                                   Effort*
                    and English)




   #
    Assistant investigator is defined as a assisting researcher in this project. PI, co-PI, Assistant investigator and
     visiting personnel will not receive salary in this project.
   *Percent of effort is defined as the percentage of the hours devoted to this project to the total working hours per
     month. For instance, 50% means this individual will devote a half of his/her working hours to this research
     project each month.

   3) If requesting funds for postdoctoral research fellows , indicate the followings for each year of the
      project:
     (1) Field(s) of specialization
     (2) Role and research work
     (3) Contribution or impact on this research project
     (4) Standards of performance evaluation
     (5) If a candidate of postdoctoral research fellow has already been selected, provide candidate’s name
          and attach his/her curriculum vitae (Form FS17 & Form FS18).




                                                                                                                         4
                                                                                                                 5
 Form FS05

5. Personnel Expenses:
      Indicate the number of full-time assistants (already holding master’s, bachelor’s, technical college, or
      high school degrees), part-time research assistants (including Ph.D. students, master’s students,
      undergraduate students, lecturers, and teaching assistants, part-time labors), postdoctoral research
      fellows and foreign visiting personnel for each year and the entire term of project period.
                                                                                            Currency unit: NTD
       Project Year
                                                                                               Total amount for
                         1st Year    2nd Year       3rd Year        4th Year       5th Year    Entire term of
               Salary
                                                                                               Project Period
Type/Rank



Full-time Assistants


Rank, Number and
Amount of NTD:




Part-time Research
Assistants


Rank, Number and
Amount of NTD:



Postdoctoral
Research Fellows


Rank, Number and
Amount of NTD:




Foreign Visiting
Personnel




Subtotal for Each Year
& Total of 5 years:




                                                                                                                 5
                                                                                                                   6
FormFS06

6. Consumable Expenses:
    1) Fill in this form with all other necessary expenses directly related to this research proposal, including
       the expenses for consumable equipment, chemicals, computer time, surveys, instrument installation/
       insurance/delivery, instrument maintenance, printing, photocopy, stationery, postage, communications
       information retrieval, domestic travel, registration for domestic conferences (excluding membership
       fees or annual dues), accident insurance, publications (for NSC-funded research results only),
       consultation fees, instrument or computer hardware rental, complimentary gifts or meals for
       experiment subjects and review fees for human studies, and other items (less than NTD10,000 or used
       for less than two years).
    2) Under “item,” categorize as either consumable or miscellaneous.
    3) Under “description,” provide in details about product specifications, functions, and other relevant
       information.
    4) If the participating institution provides support or funding, indicate the amount in “remarks” column.
    5) Complete the table with separate sections or separate pages for each year.

   Project Period:                                                           Currency unit: NTD Thousands

                                                   Unit                      Unit
            Item             Description      (“Piece,” Batch”,   Quantity   Price      Amount     Remarks
                                                “Box,” etc.)




                                           Total




                                                                                                                   6
                                                                                                                   7
FormFS07

7. Equipment Expenses:
   1) Under “type,” indicate whether the item is instrument, computer software/hardware, or book.
   2) Under “equipment,” indicate the names of the instrument, computer software/hardware, or book.
   3) Under “description,” provide detailed information of the specifications and functions of said
      equipment.
   4) If participating institutions or other organizations provide funding for equipment, indicate the
       names of supporting institutions and the amount provided.
   5) For each piece of equipment costing more than NTD600,000, provide detailed information of
      specifications and functions (including sensitivity, accuracy, etc.), important features, and significance
      for this project. If funds for such equipment are granted, the PI should maintain it and allow other
      researchers outside the research group of this research project to make full use of it, provided that
      such use does not interrupt the research work described in this proposal.
   6) Complete the table with separate sections or separate pages for each year.

   Project Period:                                                       Currency unit: NTD Thousands
                                                                                       Funds requested from:
      Type           Equipment      Description Quantity       Unit       Amount                   Other
                                                                                        NSC
               (English/Chinese)                               Price                             Institution




                                 Total




                                                                                                                   7
                                                                                                       8

FormFS08

8. Large Equipment Center Charge:
  (Skip this form if the proposal without large equipment center charge.)

  1) Websites for Large Equipment Centers:
      http://www.nsc.gov.tw/vi/DFAULT.htm
      http://www.nsc.gov.tw/org-lab-1.htm.htm
  2) Specify each year’s requirements.
                                                                        Currency unit: NTD Thousands
                                                                   Charge
     Equipment                Descriptions          Points                             Note
                                                                   Amount




                     Total




                                                                                                       8
                                                                                                             9
Form FS9
9. Travel Expenses for Mainland China and International Destinations:
  (Skip this form if the proposal without travel expenses for Mainland China and international.)

   1) Under “type of travel expense,” indicate whether it is experiment, research, or field survey, etc.
   2) Fill in separate itineraries and travel routes for each person, should these be different.
   3) Amount of funding provided for subsistence, airfare and other expenses can be found at the
      following websites:
      For international travel: http://nscnt22.nsc.gov.tw/research_res/plan/general/91GVFGRS.htm
      For Mainland China: http://www.nsc.gov.tw/research_res/plan/general/91ldst.htm
   4) When apply for Mainland China travel expenses, to fill up a form FS10(in Chinese) is also
      required.
   5) Complete the table with separate sections or separate pages for each year.

    Project Period:
                      Travel Expenses for Mainland China and International Destinations
                Item                 Expense                             Description
           Transportations
             subsistence
               Others
               Total
                                        Type of
       Traveler’s
                        Role in Project Travel        Itinerary and Work Details              Duration
         Name                                                                             (M/D/Y~M/D/Y)
                                        Expense




   5) If applying for travel to Mainland China, describe in detail the following items for each year:
     (1) Describe significance of this research project in terms of the potential academic, technological,
         social, or economic contributions to Taiwan.
     (2) Describe any special assistance provided by Mainland Chinese research organizations, including
         equipment and personnel.
     (3) Describe any support or matching funds provided by the participating institution (or other
         institutions) for short-term research trips to Mainland China.



                                                                                                             9
                                                         10
Form FS10
       10. 補 助 學 者 專 家 赴 大 陸 地 區 從 事 短 期 科 技 研 究 申 請 書
                 (無赴大陸地區從事短期科技研究者免填本表)
  請檢附:
    1.大陸地區協助研究機關(構)之同意書、邀請或許可文件。(各一式四份)
    2.其他費用包括證照、保險或其他相關費用等。
    3.請將所列各項費用換算為台幣後,加總填入合計欄內,並於說明欄內註明估算匯率。有關
      此部份之工作心得報告應於計畫執行完畢後以附件方式併同研究計畫成果報告繳交。

 一、基本資料:
            申請人姓名               身分證號碼

                                          _________個月,
                           預定赴大陸地區研究
                                          自__年__月__日起
       推薦機構及系所
                                          至__年__月__日止
                           期限

      擬赴研究處所(請

      填寫前往地點及

      學校機關名稱)

       申     補助項目     預 估 經 費              說    明

       請     交 通 費

       補     生 活 費

       助     其他費用

       費
             合    計
       用

 二、研究內容:(請就下列各項分年列述並詳盡填寫,若篇幅不敷使用,請另紙繕附)
     (一)本計畫赴大陸研究之必要性及對台灣地區學術、科技、社會、經濟各層面之可能貢獻性。
     (二)大陸地區協助研究之機構,其研究設備及人力配合情形暨特色。
     (三)申請單位提供本計畫赴大陸地區短期科技研究之相關經費(或配合款)編列情形。




                                                         10
                                                                                                              11
Form FS11
11. Travel Expenses for International Conferences:
  (Skip this form if the proposal without travel expenses for international conferences.)

   1) Only PIs and Ph.D. research assistants are eligible for this funding.
   2) Describe nature of conferences, proposed budget, venues and duration.
   3) Briefly describe any participation in international conferences in the past three years. Indicate
      conference titles, dates, venues, sponsoring organizations, and titles of conference papers presented
      therein. For any publications resulting from the conferences, provide name of journal or
      publication, volume, page number, and date of publication.
   4) Fill in the descriptions of international conference travel separately for each year.




                                                                                                              11
                                                                                                                12
Form FS12
 12. Previous and Current Research Projects and Submitted Proposals
         List current and previous research projects within the past 5 years and the proposals that have been
         submitted to any funding organization for grant application.

    PI’s Name: ________________                                                 Currency unit: NTD Thousands

                                                                                                    Percentage of
Title of Research Project        Role                                       Amount      Duration
                                            Percent of     Supporting                                overlapping
 (For NSC grant applications,      /                                          of        (M/D/Y~
                                Position      Effort      Institution(s)                                 with
indicate grant number)                                                      Funding      M/D/Y)
                                                                                                    this proposal




                                                                                                                12
                                                                     13
Form FS13

13. English Abstract and Keywords (maximum 500 words for abstract)




                                                                     13
                                                  14
Form FS14

 14. 中文摘要及關鍵詞   Abstract in Chinese(中文摘要以五百字為限)




                                                  14
                                                                                                           15
Form FS15

15. Contents of Research Proposal:
   1) Summarize achievements and/or progress of the past five years directly related to this research
      proposal.(Provide the results of the previous one of granted frontier science project, if any.)
   2) Describe the significance of this research proposal including prospects for academic excellence,
      innovations in scientific research or technological development, and impact on research field and
      international competitiveness.
   3) For each year of the project, specify the objectives as well as material and methods.
   4) Specify the anticipated results and accomplishments for each project year.
   5) Describe the research infrastructure in pIs’ institutions including possibility of matching funds,
      working space, facilities, etc.
   6) Provide references.




                                                                                                           15
                                                                                            16
Form FS16
                 行政院國家科學委員會個人資料表
一、基本資料                                            簽      名:

        身分證號碼                                           填表日期: 20        /       /

   中文姓名                          英 文 姓 名
                                            (Last Name) (First Name) (Middle Name)
   國        籍                    性     別 □ 男 □ 女 出生日期 19                    年       月   日
   聯 絡 地 址 □□□□□


   聯 絡 電 話 (公).                               (宅/手機).
   傳真號碼                                       E-MAIL

二、主要學歷          由最高學歷依次填寫

             學校名稱           國別       主修學門系所             學位     起訖年月(西元年/月)
                                                                    /   至           /
                                                                    /   至           /
                                                                    /   至           /
                                                                    /   至           /

三、現職及與專長相關之經歷               指與研究相關之專任職務,請依任職之時間先後順序由最近者往前追溯。
             服務機構                服務部門/系所               職稱      起訖年月(西元年/月)
   現職:                                                              /


   經歷:                                                              /   至           /
                                                                    /   至           /
                                                                    /   至           /
                                                                    /   至           /
                                                                    /   至           /
四、專長        請自行填寫與研究方向有關之學門及次領域名稱。
   1.                2.                3.                      4.




                                                                                            16
                                                                                                                  17
Form FS17

                                       Curriculum Vitae

 Please provide the following information within 4 pages:
  1) Name, Gender, Birth date.
  2) Education.
  3) Current position and relevant experience.
  4) Fields of specialty (limit to fields related to research)
  5) Major awards and honors.
  6) Significant project-related publications in the past 5 years, including technical reports, patents, periodical
     articles.




                                                                                                                  17

								
To top