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CRACK IT Solutions Funding Application Form Background information All applications will be treated in confidence. Applicants should consult the Guide for Participants which provides further details of the competition. Any questions should be addressed to [email protected] or +44 (0)20 7611 2233. Completed application forms should be submitted by email (as a Word document) to [email protected]. Applications will be reviewed at quarterly assessment meetings. Applications submitted after a submission deadline will automatically be considered at the following review meeting. Full details of submission deadlines and corresponding review meetings dates can be found at www.crackit.org.uk/crack-it-solutions/apply-for-solutions-funding. The application form should be completed using Arial font, size 10. THE CELL SIZES ARE FIXED. If the text you enter is not visible within the cell it may not be read. To select from a dropdown list (currently marked “Please Select One”) click on the writing and make your selection. Keep the use of acronyms to a minimum. In order for your application to be accepted you must submit all the required information including all mandatory fields in the application form. Additional information can be provided in appendices as indicated in the application form; appendices must be titled APPENDIX and include the appendix reference of A, B, C or D plus the lead applicant’s name. For more information on the NC3Rs please see www.nc3rs.org.uk. Terms and Conditions The NC3Rs use personal data submitted in the CRACK IT Solutions application form for purposes associated with the application and award processes for the CRACK IT Solutions funding competition. Your personal data may be used in relation to: the registration of your proposal; resolve any queries which you may raise with the CRACK IT team; the operation of application processing and management information systems; the acquisition of UK and/or international peer reviewer comments on proposals; the preparation of material for use by the Funding Review Panel to assess your proposal; payments made to your organisation; statistical analysis in relation to the evaluation of research funded by the NC3Rs; invite you to participate in events related to the CRACK IT Solutions competition or other relevant events hosted by the NC3Rs. By agreeing to these terms and conditions, and submitting your proposal, you have explicitly consented to your personal data being processed by us in this way and stored on the system and on our associated internal systems. To maintain public accountability, the NC3Rs may publish or disclose into the public domain details of awards made in the CRACK IT Solutions funding competition. Disclosable information includes: the title of your award; your name; the organisation at which you are working; the dates associated with your award; the funding provided to the institution. Project Number (for office use only): 1. Application Project Title: Please provide your own title for the project. This should be both clearly descriptive and concise. It should contain keywords relevant to the project Project Duration (months): Proposed Start Date: Total Project Cost (£’s): Solution Title: Refer to www.crackit.org.uk/crack-it-solutions/view-solutions for current Solutions. 2. Details of Lead Applicant Organisation Organisation Name: Registered Address: Country: Region: Please Select One Company Registration Number: VAT Registration No: Website: Size: Please Select One Main Activity: Type of Organisation Please Select One 3. Contact Details of Lead Applicant Title: Name: Position: Organisation: Main Correspondence Address: Country: Phone: Extension: Fax: Mobile: Email: Status: Please Select One 4. Collaborator Details If more than one collaborator is providing support to the project they should be included in an appendix (A) in the same format as in this section. Title: Name: Position: Phone: Extension: Fax: Mobile: Email: Organisation Name: Registered Address: Country: Region: Please Select One Company Registration Number: VAT Registration Number: Website: Size: Please Select One Status: Please Select One Main Activity: Type of Organisation Please Select One 5. Description of Business/Scientific Need for the Solution (230 words max.) Avoiding the use of unnecessary technical jargon please provide a description of the business and/or scientific need that will be addressed by the Solution and how this will impact on the research and development activities of the collaborating organisation(s). You may wish to add pictures or diagrams to support your response to this question in an Appendix (B) maximum 2 sides of A4, to be submitted separately. 6. Scientific/Technical Project Summary (Max. 700 words) Please give a summary of the scientific/technical basis of your project to develop/validate the Solution. Explain the scientific/technical challenges that will need to be overcome and describe how this will be achieved, including backup strategies. List the key scientific/technical deliverables. In this section, include where necessary the in-kind contributions provided by the external collaborator to support the development/validation work. 7. Current State of the Art and Intellectual Property (Max. 350 words) Describe the current state of the art and any competing or alternative strategies. Explain the benefit of your proposed Solution. Include details of any other existing IP and its significance to your freedom to operate. Include details of your own background IP and any restrictions this may impose on the dissemination and exploitation of the project findings. Ownership and exploitation of foreground IP should be included in section 8. 8. Project Plan and Methodology Please describe the key project milestones at appropriate intervals and scientific lead for each milestone. Highlight what resources will be required to address the technical challenges (in descriptive terms only e.g. personnel, types of equipment) and what the key success criteria would be. Please note that the resource column should indicate details of the in-kind contributions that will provided by the collaborator(s). The emphasis throughout should be on practicality – we are seeking evidence that the Solution works and is a viable approach to solving a business/scientific need and can achieve the proposed benefits. Further information on the milestones and a Gantt chart must be provided in an Appendix (C), limited to 2 A4 pages. Milestone and scientific lead Date Resources Success Criteria Project Management – Identify the project management processes that will ensure milestones are achieved in a timely manner. In addition, provide details of identified risks and mitigation actions.(Max. 70 words) Proposed arrangements for IP – Please provide an indication of how any IP which might arise during the project would be handled i.e. the proposed arrangements for ownership, exploitation and dissemination. (Max. 70 words) 9. Scientific/Technical Team and Expertise (Max. 700 words) Please provide a brief description of your scientific/technical team, the skills and expertise of each member relevant to this application and the proportion of their time they will be spending on the project. Relevant commercial and management expertise should also be included. The CVs of no more than five principal team members may be provided in Appendix D limited to one A4 page each. 10. Application finances Please provide a summary of costs requested. All CRACK IT Solutions awards are subject to VAT at 20%. Applicants must cost their award and enter a total excluding VAT. VAT will be added to the amount of the award by the NC3Rs. CRACK IT Solutions funding is provided to meet only direct costs associated with the research and development work. Indirect costs, including general office and basic laboratory consumables; library services/learning, cannot be funded through CRACK IT Solutions funding: itemisation of costs and methods of calculation may be requested to support the application at a later date. Each application will be judged in terms of value for money i.e. does the proposed cost for effort and deliverables reflect a fair market price? Total Costs (£), excluding VAT Labour costs Materials Costs Capital Equipment Costs Animal Costs Travel and Subsistence Costs Other Costs (specify) TOTAL COSTS Please provide information on funding from the collaborator(s) or other public and private bodies Source Amount Funded Cost justification - please provide justification of costs (Max. 250 words) Provisional/Confirmed 11. 3Rs Impact Assessment (Max 350 words) The Solution outlines the potential 3Rs benefits arising from the successful completion of the project. Please provide your own assessment of the 3Rs impact of the work, including qualitative assessment of the 3Rs benefits and quantitative estimates of the numbers of animals affected wherever possible. Please also consider the wider application of the Solution beyond the current application and the 3Rs benefits of this. 12. Plans for Dissemination and Uptake of the Solution (Max. 350 words) Please provide details of your dissemination strategy and plans to encourage wider uptake of the Solution following completion of the project. 13. Declaration The lead applicant is expected to have discussed the application within their own company and any other body whose co-operation will be required to deliver the project. If successful, the lead applicant will need to obtain consent from an authorised officer or appropriate signatory who will sign the contractor agreement. By submitting the application you are confirming that the information given, in this application, is complete and that you are actively engaged in this project and responsible for its overall management and agree to administer the award if made. You are also confirming that you have read and understood the relevant explanatory materials i.e. the Guidance Notes and the Guide for Participants. I hereby confirm that I fully comply with the declaration as stated above (please tick the box to confirm). THIS FORM MUST BE SUBMITTED BY EMAIL TO [email protected].