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Global Commerce Support Program - Going Global Innovation APPLICATION FORM SECTION 1: Project Lead Information 1.1 Project Leader Name: Legal Name of Institution/Organization: Telephone: Fax: E-mail: 1.2 Organization A. Main Address Number and Street: City: Province: Postal Code: Type (Academic, Industry, Non-government research institute): B. Mailing Address Number and Street: City: Province: Postal Code: C. Courier Address Number and Street: City: Province: Postal Code: 1.3 Authorized Signing Authority for the Institution Name: Position: Institution/Organization: Address: Telephone: Fax: E-mail: SECTION 2: Project Information 2.1 Project title (in 10 words or less): 2.2 Proposed project dates (overall for entire project): 2.3 Proposed travel dates (overall departure & return) 2.4 Applicable research area(s) (select all that apply): (Please tie the research area to the intended application/outcome of the R&D) Environmental science and technologies Natural Resources and energy Information and Communication Technologies Health and related life sciences and technologies Other: . 2.5 Executive summary of the project (brief synopsis of what this mission wants to achieve maximum 500 words): 2.6 What are the objectives and expected outcomes of the project? 2.7 Clearly and concisely explain the proposed joint partnership. 2.8 What methodology is being used in order to advance/solidify this partnership?( for example will there be a workshop, one-on-one meetings, presentations, site visits etc). If there is an agenda for the project, please include. 2.9 Clearly and concisely outline the roles of both the Canadian and foreign participants. 2.10 Describe the complementary knowledge, expertise or technology being brought to the collaboration by the foreign counterpart(s), making sure to explain clearly why this knowledge, expertise or technology is not available within Canada or why these foreign counterparts are ideal partners. 2.11 Describe potential downstream activities (research, commercialization) that is expected to flow from this joint R&D collaboration. 2.12 Explain the funding sources being planned for subsequent stages related to the R&D collaboration. (e.g. Venture Capitalists, Angel investors, company revenue, government sources, granting councils, etc.. SECTION 3: Participant and Partner Information 3.1 Other Canadian Participants: (list each Canadian participant) Name: Institution: Mailing address: Telephone: Fax: E-mail: Type (Academic, Industry, Non-government research institute): 3.2 International Counterparts: (list each foreign participant) Name: Institution: Mailing address: Telephone: Fax: E-mail: SECTION 4: Activities Activity Details (list for each activity) Activity Title Date of Description Destination Travel # of # of Foreign Canadian Participants Participants Total number of participants xx xx SECTION 5: Prior Going Global Experience 5.1 Have you previously applied for Going Global funding? Was your project approved under the program?
"Going Global Science & Technolog"