If the Application Mentioned Above Is Awarded a Rubicon Grant, the Institute

Rubicon: form of acceptance, in case of employment at the host institute (deadline 31 August 2017, 14.00 hrs. CE(S)T)

To be forwarded by the receiving institute directly to the applicant. Note: It is the applicant’s responsibility to attach this form to her/his grant application form and to submit it in electronic form using the online application system ISAAC. The application will only be accepted when this form is signed by the host institute’s authority to guarantee employment. The guarantee will be revoked if the application is declined.

1. Employment

If the application mentioned above is awarded a Rubicon grant, the institute name of institute:…………………………………………… will employ name of applicant:………………………………………… for the research at least the period mentioned underneath. The applicant will receive the local employment conditions comparable to temporarily employed postdoc researchers at the institute. By signing this form the institute also accepts the Rubicon Terms and Conditions under which the grant will be awarded.

2. Details and period

The application of name of applicant:…………………………………………………………………… to conduct research at name of institute: …………………………………………………………………… during the approximate period from start date:………………… to end date:…………………… is hereby accepted (1)

By accepting the recipient of the grant, the institute accepts the responsibility of protecting both itself and the recipient as appropriate to the normal needs of a postdoc researcher. The host institute accepts to provide the necessary materials and facilities. NWO does not have an employment relation with the recipient and cannot accept liability for his/her actions, health, safety or research expenditures. NWO does not provide “bench fees” or any other financial contribution to the costs of the research other than described in the programme brochure. 3. To assist the NOW/ZonMW Selection Committee in reaching a decision about this application the proposed scientific supervisor is kindly requested to outline why he/she wishes to have the applicant work in his/her institute.

4. Furthermore, please describe in what way the proposed research fits the already existing research line(s) at your institution.

5. Ethics aspects

Possible relevant ethical aspects are: - research on animals - informed consent - privacy and data protection - research on human Embryonic Stem Cells - research involving developing countries - biosecurity/dual use

Please indicate whether the research to be conducted has ethical aspects. (See for more information the Call for proposals, 3.5.1. Ethical aspects) YES ☐ Not applicable ☐

If yes please explain (including any measures which have been or will be taken with regard to ethical aspects of the research): 6. Signatures

1. Proposed scientific supervisor (host institute)

……………………………………………… Name

……………………………………………… Date and Place

……………………………………………… Signature

2. Human resources officer1 (Host institute) ……………………………………………… Name and Position

……………………………………………… Date and Place

……………………………………………… Signature

1 The HR officer or other staff member who has the authority to guarantee employment.