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TTPD-Application-Form

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0% found this document useful (0 votes)
9 views7 pages

TTPD-Application-Form

Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as DOCX, PDF, TXT or read online on Scribd
You are on page 1/ 7

‫أكاديمية البحث العلمي والتكنولوجيا‬

‫برنامج نقل التكنولوجيا وتطوير المنتجات وتعميق التصنيع‬


‫المحلي‬
TTPD/DLM Application Form
Title of the
Proposed
project:
Arabic/English
Field of the Technology Transfer, Product Development and Deepening
proposal Local Manufacturing Program
Name of
Applicant:
Arabic/English
Affiliation of the
applicant:
Name and
contact
information of
Industrial
partner/End user
(Letter of Intent
is required)
Requested *Industry/Private Sector
ASRT Share: Total:
Budget (EGP): Share:
Duration of the
project:
Type of the
Technology Transfer, Product
project: Deepening of Local
Development and/or technology
(Please check Manufacturing (DLM)
(know-how) production
one only)
Host Institution
Principal
Name:
Approvals Investigator
Title:
Name:
Signature:
Signature:
Date:
Date:
Seal:
Date of
Submission

Intellectual Property Rights (IPR):

- All issues related to IPR, royalty and revenue/profit must be


discussed case by case and accepted by all parties in the light of
governing rules, IPR policies and laws (law no. 82/2002).
- Any type of publication is not permitted without written permission
from ASRT, and the ASRT fund must be acknowledged.

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- Transferred technologies and all items purchased with funds from
this grant will remain the property of the ASRT and not of the person
or institution to which the grant is made. However, the applicant will
have first use of any such items.

*an endorsement letter form the industrial partner, with clear


commitment and participation, is needed

Part A-1: Short CV of the PI


(One page maximum)

1. Basic Information
Full Name in Arabic: Full name in English: (As you write it
in International publications,
underline family name):
Date of Birth:
National ID
Last University Degree: Faculty, University, Country: Graduation Date:
Title: Field of specialization:
Affiliation:
Current Position:
Contact Information:

Mobile Phone: Fax: E-mail:


2. Scientific Achievements
h index Citations Total no. of Int. publications in
Scopus
Last three recent relevant publications
Authors (underline your name), year, title, Journal, vol. and pages
1

3
Patents:
Granted Patent(s): Submitted patent(s):
Title of the patent: Title of the patent:

No. of the patent: No. of the patent:

If applicable, state other tangible scientific and technological achievements


such scientific prizes, research grants, presence of a prototype, documented
successful applications, products …etc.

Please list other ongoing projects funded by either ASRT or other funding
organization (ID of the project, Monetary value of the grant, Title, Start and

Page 2 of 7
end dates)

Part A-2: Co-PI and Team members


(One page maximum)
Positi
Contact
on Role in NID h-
Field of Informat
N Name & Affiliati (Prof., the ‫الرقم‬ index Signa
specializ ion
o Signature on A. projec ‫القوم‬ (Sco ture
ation (Tel.,
Prof., t ‫ي‬ pus)
Email)
…..etc
1
2
3
4
5
6
7
8
9
1
0

Signature of the PI:


Approval and stamp of the host institution

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Part B: Proposal
The proposal should not exceed 10 pages maximum

The proposal must include the following:

B.1. English Summary: it should describe the proposed research


activities, objectives, methodology, expected outcomes and impact

B.2. Arabic Summary: is an understandable translation of the English


summary.

B.3. State of the Art: this section must give solid justifications
regarding the importance of the project in the light of the state of the art
in the project subject area and advantages of your proposal

B.4. Objectives: Briefly and concisely state your project’s main and
specific objectives

B.5. Outcomes and Impact: List your expected project’s outputs as


given in this form

B.6. Approach and Methodology: Briefly describes how your project


will be implemented, including your general scientific approach, activities,
methods, and project inputs. Specify the methods only to the extent
needed to give a general idea of the tasks to be conducted and the
findings it will yield. Provide any preliminary results or prototype that has
already been implemented

B.7. Key References: List outstanding, recent and relevant literature


cited in the proposal and source of given statistics

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Part C: Gantt chart and Logical Framework Matrix (LFM)
(You may add extra rows if needed*)
Expected

End Date

(Months)
Duration
measurable

Start
Date
Task outcomes of

M1
M2
M3
M4
M5
M6
M7
M8
M9
Task Title
No. successful
implementation
of the task

Signature of the PI:


Approval and stamp of the host institution

The Gantt chart is a graphical representation of a project’s schedule which illustrates the
work breakdown structure. To develop the Gantt chart, start by specifying the main
tasks/ activities making up the project. Then break down each main task/ activity to its
sub tasks/ sub activities. The time required for each task/activity and sub tasks/sub
activities is represented as a horizontal bar on the chart. Those horizontal bars of varying
lengths represent the sequences, timing, and time span for each task/sub task. A column
titled: expected measurable outcomes as a result of successful implementation of each
task was added to Gantt chart, accordingly this table is a merge between Gantt chart and
LFM.

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Part D: Budget
(The budget should be justified in details in another table according to tasks and
outputs should be achieved)

Cost in
EGP
Item Justification
(ASRT
share)
Incentives
(maximum 5%, and the incentives
should not exceed 200,000 EGP)
Scientific Equipment,
Supplies, Consumables, and
analysis:
this budget item also covers spare
parts, maintenance and accreditation
costs, materials, software tools and
analysis of samples
IPR Protection Costs:
Patent, Utility model, Trade mark and
Product registration
Research Assistants:
Outsourcing of graduate students, IT
Engineers, Designer and Technicians,
…etc.
Technology Transfer Costs:
Technology licensing, feasibility study,
testing and certification
Needs in advance approval of ASRT
Others:
Manufacturing costs, testing,
certifications and licensing, local and
Int. Travels (Needs in advance approval
from ASRT)
Overhead (5%)
Total

Part E: List of equipments and/or machines available at the


applicant institution or other institutions for successful
implementation of the project
(You may add extra rows if needed)

Instrument/spare Proposed uses &


No. Institution
part Justification
1
2
3

Page 6 of 7
4

Part F: List of expected outcomes from the Successful


implementation of winner proposals
(KPIs for follow up)
(One page maximum)
Description
Chec (Reference of publications, number
Numbe of the patent, Tile of MSc and PhD
k Expected Outcome
rs thesis, Name of graduate students,
Box Labs and equipment, conferences, ….
etc)
Publications in Q1-Q2,
Filed and/or awarded
☐ Patents, Utility Model,
Trademark, Trademark,
Software, …etc.
Establishment of National

Core Facilities (NCF-Lab)
Developed

Technologies/Know How
Technology Transfer &

Licensing
Deepening Local
Manufacturing
☐ (Name locally
manufactured product or
spare parts)
Signed contracts and/or
revenue from marketing
☐ and /or application of
generated technologies
or know-how
Spinoff/Start-ups resulted

from the project

Page 7 of 7

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