Place, Date and Signature

PROTOCOL

RESEARCH PROPOSAL FORM

FAPESP/FAU CALL FOR PROPOSALS 2017 RESEARCH PROPOSAL FORM

1. PRINCIPAL INVESTIGATOR - FAPESP (do not omit or abbreviate names) NAME:

INSTITUTION (University):

UNIT (College, Center, Institute):

DEPARTMENT:

2. PRINCIPAL INVESTIGATOR – FAU (do not omit or abbreviate names) NAME:

INSTITUTION (University):

UNIT (College, Center, Institute):

DEPARTMENT:

3. PROJECT TITLE (do not abbreviate)

4. PROJECT TYPE AND TIMEFRAME AREA OF EXPERTISE: PROPOSED START DATE: PROPOSED ENDING DATE: PROJECT DURATION:

5. KEYWORDS, please insert (up to) ten representative keywords characterizing the scientific Project

1 6. RESEARCH PROJECT SUMMARY IN ENGLISH

2 7. SUMMARY OF THE FUNDING REQUESTED FROM FAPESP BY THE SÃO PAULO STATE RESEARCHERS FOR THE DEVELOPMENT OF THE PROJECT – FAPESP Team only

EXPENSES IN R$ (please use a coma to separate the decimals)

1) AIR TICKETS

2) PER DIEM

3) HEALTH INSURANCE

3 8. SUMMARY OF THE FUNDING REQUESTED BY THE PRINCIPAL INVESTIGATOR FROM FAU SIDE FOR THE DEVELOPMENT OF THE PROJECT – FAU Team only

EXPENSES in € (please use a coma to separate the decimals)

1) AIR TICKETS

2) PER DIEM

9. GRANTS REQUESTED TO OR AWARDED BY OTHER FUNDING AGENCIES RELATED TO THE PROPOSAL (please indicate the currency) INSTITUTION TOTAL REQUESTED TOTAL AWARDED

10. STATEMENT FROM THE DIRECTOR OF THE UNIT WHERE THE PROJECT WILL BE DEVELOPED

I declare that in case this Project is approved and for the duration of its grant, the researcher and group of researchers taking part in the project will have all the institutional support necessary for its development, as previously agreed with the Principal Investigator. Specially, the researcher and research group taking part in the Project will be granted with physical space, the permission to use all facilities (laboratories, computer networks, library, databases etc.) and access to all services (lab technicians, administrative support etc.) available at the institution and that are relevant for its fulfillment. If the development of the project is hindered or made impracticable due to the non-fulfillment of this clause and without previous consent from FAPESP, the Institution commits itself to reimburse FAPESP’s related expenditures. I am aware that the failure to fulfill the terms of this statement may compromise the course of future requests applied to FAPESP by researchers from this Unit. NAME: POSITION/TITLE: PLACE, DATE AND SIGNATURE:

11. APPLICANT STATEMENT

1- I declare to be aware of the procedures adopted by FAPESP and FAU for the analysis of proposals in this call. 2- I authorize this proposal to be analised according to these procedures and specifically to submit it to the analysis of ad hoc advisors chosen by FAPESP and FAU, whose identities will not be disclosed. PLACE, DATE AND SIGNATURE

ATTENTION: CONFER DOCUMENTS TO BE ATTACHED 

4 12. MANDATORY DOCUMENTS TO BE ATTACHED

MANDATORY DOCUMENTS TO Check-list FAU, INCLUDING THIS FORM, Applicant FAU Research Project SummaryREQUIRED (including FOR all items described in section 6.1 of the CFP) CV Summaries of the PIs from both Parties and of each mission candidate on both sides Budget forms

Worksheet listing the candidates for the exchange missions A Letter of Agreement or a Letter of Intent between the Partner Institution abroad and the Higher Education and Research Institution as described in section 6 of the Call for Proposals. This document is not mandatory for the submission of proposals, but the presentation of a copy of the signed ATTENTION: ALL PROPOSALS SENT TO FAU THAT ARE NOT ACCOMPANIED BY THE MANDATORY DOCUMENTS FOR ANALYSIS WILL NOT BE EVALUATED AND WILL NOT BE RETURNED.