Technopreneur Investment Grant Scheme UM Application Form by nuhman10

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									          UNIVERSITY OF MALAYA
          TECHNOPRENEUR/ ENTREPRENEUR
          INVESTMENT GRANT SCHEME
          PROGRAMME
________________________________________________

Grant Application Form and Notes
Please read these Notes before completing the Application Form.

FUNDING PROGRAMME

                                            TECHNOPRENEUR / ENTREPRENEUR GRANT
Introduction                  Grants of RM5, 000 to RM50, 000 are available to all non-final year students
                              (undergraduate and postgraduate), lecturers, societies, associations or other
                              bodies in the university.

                              Technopreneur / Entrepreneur Grant can cover projects in most academic,
                              professional, arts, cultural and educational fields. New innovation and
                              technology are encouraged to apply.
How to apply                  Complete the Application Form and post THREE copies of your application to:

                              Technology Transfer and Commercialization Unit (UPTK)
                              Ground Floor, Block A,
                              City Campus Complex University of Malaya
                              Jalan Tun Ismail
                              50480 Kuala Lumpur

Deadlines                     There are three (3) application deadlines each year:
                               First Cycle: 31 March (for a decision by 31 April)
                               Second Cycle: 31 July (for a decision by 31 August)
                               Third Cycle: 30 November (for a decision by 31 December)
                              However, applicants are encouraged to submit their application as early as
                              possible.
What kind of project is NOT   Entrepreneur Grants cannot be used for:
eligible?                      general appeals
                               capital expenditure (eg, building refurbishment, equipment acquisition, etc)
                               consumables (eg, stationery, scientific supplies, etc)
                               school, college or university fees
                               salary costs or professional fees
                               commissions for works of art
                               replacement of statutory funding
Decision                      All applicants are notified by letter from the UPTK unit. The decision of the
                              Committee is final and the unit is unable to discuss unsuccessful applications.
Traning                       Successful applicants shall undergo an extensive entrepreneurship
                              programme
COMPLETING THE APPLICATION FORM

   The Application Form is designed for use on a computer but can be printed and completed in BLACK
    ink by hand using CAPITAL LETTERS or with a typewriter.
   Enter text in or tick the boxes provided. DO NOT ALTER ANY OTHER PART OF THE FORM.
   The form MUST be completed in English. Any financial information MUST be given in Ringgit Malaysia
    (RM)


Section 1 – Project Leader
The Project Leader is the person or organisation leading the project and responsible for administering a
grant if an application is successful. Please be aware that the committee may need to contact the Project
Leader during the assessment of the application.

Section 2 – Project Team(s)
Project Partners are the people or organisations working with you on your project. If you have any Project
Team(s), please give their details.

Section 3 – Supervisor/ Advisor
Each project must have at least one Lecturer as the Supervisor or Advisor to guide the project.

Section 4 – Previous applications to the Foundation
State any previous applications for funding to the Foundation from the Project Leader or Project Partner(s).

Section 5 – Project
Enter a brief project description and the start and finish dates

Section 6 – Grant request
Give the budget for the amount you are requesting from the unit. Please state EXACTLY what you would
use any funds for in Ringgit Malaysia (RM). Give as much information as you can and be aware of what the
university cannot fund. You should be aware that successful applications may not receive the full amount
that they request.

Section 7 – Income for project from other funding bodies
Please give any other funding bodies supporting the project and whether the funding is guaranteed or
pending. Only include funding that directly affects the project, not general financial support.

Section 8 – Project background
Clearly explain the background of your project. How did you first meet or make contact with your Project
Team(s)? What previous projects have you undertaken at the university? Why did you decide to undertake
the current project? Why is your project important? If you belong to an organisation (eg, charity, community
group), what is its background and purpose?

Section 9 – Project summary
Describe the project and how it will be carried out. Who will be involved? Where will it happen? What is the
schedule of activities? If you have a detailed schedule, please include it as a supplementary material (see
Section 11).

Please also state what difference funding from the University will make to the project. Will the project still go
ahead if it receives no or partial support? If you have substantial funding from another source, please explain
why these funds cannot be used for the items listed in Section 6.

Section 10 – Project benefits
What will be the concrete outcomes of your project? For example, will there be an exhibition, a seminar,
report, product, technologies or sservices? What future joint ventures with your Project Team do you hope
will emerge from your current project?




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Section 11 – Supplementary materials
Please list any supplementary materials that you are sending in support of your application. Please note:

        CVs MUST be provided by
         o   Project Leader and Team(s)
         o   Lecturer(s) as supervisor or advisor

Please note that audio or visual recordings (eg, videos, CDs) will NOT be considered. Please do not include
them in your application.

Section 12 – Additional information
The University would be grateful if you would indicate how you found out about the grant-giving programmes.


Section 13 - Declaration
Print THREE copies SINGLE-SIDED on PLAIN WHITE PAPER. Sign and date each copy.



CHECKLIST
 Have you included any required supplementary materials?
 Have you printed THREE copies of the Application Form SINGLE-SIDED on PLAIN WHITE PAPER?
 Have you signed each copy?
 Have you checked where to post your application?




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          UNIVERSITY OF MALAYA
          TECHNOPRENEUR/ ENTREPRENEUR
          INVESTMENT GRANT SCHEME
          PROGRAMME
________________________________________________

Grant Application Form

Use this form to apply for Technopreneur / Entrepreneur Grant.
Please read ‘Grant Application Notes’ at the beginning of this document before completing the form.


1. PROJECT LEADER


Organisation

Name
Title                        Mr      Ms    Mrs        Miss    Dr    Professor    Other:
Position
Department

Address



Town


Postcode
Country
Telephone number
Fax number
Website                    http://
Email address




2a. PROJECT TEAM

Organisation

Name
Title                        Mr      Ms    Mrs        Miss    Dr    Professor    Other:
Position
Department

Address




                                                    4
Town


Postcode
Country
Telephone number
Fax number
Website            http://
Email address


2b. PROJECT TEAM

Organisation

Name
Title                Mr      Ms    Mrs        Miss    Dr    Professor    Other:
Position
Department

Address



Town


Postcode
Country
Telephone number
Fax number
Website            http://
Email address


2c. PROJECT TEAM

Organisation

Name
Title                Mr      Ms    Mrs        Miss    Dr    Professor    Other:
Position
Department

Address



Town


Postcode
Country
Telephone number



                                            5
Fax number
Website                           http://
Email address



3. SUPERVISOR/ ADVISOR

Organisation

Name
Title                               Mr      Ms    Mrs        Miss    Dr    Professor    Other:
Position
Department

Address



Town


Postcode
Country
Telephone number
Fax number
Website                           http://
Email address


3. PREVIOUS APPLICATIONS TO THE FOUNDATION

  Date           Ref number                                                    Amount          Amount received
                                              Project name                 requested (RM)
(mm/yyyy)       (if applicable)                                                               (if successful)(RM)




PROJTCTEAM

4. PROJECT DETAILS

Project description
(maximum 255 characters,
including spaces)




Start date (mm/yyyy)
Finish date (mm/yyyy)




                                                           6
5. GRANT REQUESTS

                                             Description                            RM
Grant request budget




                            GRANT REQUEST TOTAL (RM)


Total cost of the project       RM



6. INCOME FOR PROJECT FROM OTHER FUNDING BODIES

                                            Funding body                            RM
Guaranteed funding




                             TOTAL

                                                           Expected decision
                            Funding body                                       RM
                                                           date (mm/yyyy)
Pending funding




                            TOTAL




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7. PROJECT BACKGROUND




8. PROJECT SUMMARY




                        8
9. PROJECT BENEFITS




10. SUPPLEMENTARY MATERIALS




11. ADDITIONAL INFORMATION


Where did you hear about The Entrepreneur Grant Programme and its grant-giving? (Please select ONE
only)



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 Newspaper / journal
 Directory
 Internet
 From a previous applicant
 Word of mouth
 Other


12. DECLARATION


I declare that I have read the Grant Application Notes, that the statements in the Application Form are true
and that, if successful, I will abide by the terms and conditions set by The Entrepreneur Programme


Signature

Date




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