Request for Wellcome Trust VIP Funding for Open-Access Publication

Request for Wellcome Trust VIP funding for Open-Access Publication (see notes overleaf) Name and Department

Paper Title

Publication and Publisher

Is a specific payment charged for open access? (Yes/No) Proportion of work funded by Wellcome Trust Amount required (if original charge not in sterling, please note original as well) Wellcome Grant Holder’s Name

Wellcome Grant Holder’s Reference Number (Sponsor reference of format 0123345/Z/03/Z)

PubMedCentral Reference (ask your journal for this)

Please return this form and a copy of the original journal invoice to: Chad Pillinger, School of Biological Sciences, 17 Mill Lane, Cambridge CB2 1RX E-mail: [email protected] Notes on filling out the form. Information requested Notes Name and Department The name of the Cambridge author making the claim. Date Date of claim

Paper Title Title of the paper for which you are making a claim Publication and Publisher Journal title and its publisher Is a specific payment charged for We can only re-imburse you for open access? (Yes/No) charges relating specifically to Open Access; we cannot pay for standard page charges, figures or photographs etc. Proportion of work funded by The Wellcome Trust will only pay Wellcome Trust Open Access charges proportionate to the amount it funded the work by e.g. if the work was 50% funded by Wellcome, they will pay 50% of the Open Access charges. However, if the other sponsors involved in the work do not pay for Open Access charges, you may still request the full amount. Amount required (if original To cover Open Access charges charge not in sterling, please note ONLY, and proportionate to how original as well) much of the work was funded by the Wellcome Trust. Wellcome Grant Holder’s Name The Principal investigator on this grant Wellcome Grant Holder’s The Wellcome Trust’s reference of Reference Number format 0123345/Z/01/Z) You may not yet have a UK PubMed PubMedCentral Reference (ask Central reference number, but please your journal for this) inform Chad Pillinger ([email protected]) as soon as you receive this.