<p> Republic of Macedonia Ministry of Education and Science</p><p>APPLICATION FORM CALL FOR PROPOSALS SCIENTIFC-TECHNOLOGICAL CO-OPERATION Republic of Macedonia - Austria 2018 - 2020 Deadline for Applications: 31.12. 2017</p><p>Information on the project</p><p>Tick the appropriate box: New application (a co-operation with the partner institution has not been supported by WTZ by now) Application for prolongation (a co-operation with the partner institution has already been supported by WTZ) </p><p>Personal data of the project leader</p><p>First and last name, academic degrees </p><p>Position: </p><p>Date of birth: </p><p>Gender: w m</p><p>Project description</p><p>Project title (in German*, optionally also in English):</p><p>Brief project description: </p><p>Project description including methods section see attachments (3-5 pages):</p><p>Research organisation in Austria: </p><p>Address: </p><p>Phone / Fax / Email: </p><p>Names of all team members on Austrian side (age, sex):</p><p>Project partner in Macedonia </p><p>Project leader: </p><p>Research organisation in Macedonia: </p><p>Address: </p><p>Phone / Fax / Email: </p><p>Team members on Macedonian side: </p><p>1/5 Please list all planned trips and stays for 2018/19 in the following year overview:</p><p>Stays of Macedonian project participants in Austria 2018/19 according to the rates(=> see announcement)</p><p> duration of stay Number of trips Living cost Name approximate dates / activities (days/ months) to Austria in Austria in EUR</p><p>TOTAL </p><p>Trips of Austrian project participants to Macedonia 2018/19</p><p> duration of stay Number of trips Travel expenses Name approximate dates / activities (days/ months) to Macedonia in Macedonia</p><p>TOTAL </p><p>Total cost for trips and stays requested in 2018/19:</p><p>Total visits and stays financed by the Austrian side in 2018/19</p><p>Calculated total costs Total stays of Macedonian team for 2017 in EUR Total number of trips of Austrian team members in Austria (days and/or Living costs in Austria+ travel costs to members to Macedonia months) Macedonia (max. EUR 3.000,- per year)</p><p>Total visits and stays financed by the Macedonian side in 2018/19</p><p>Total stays of Austrian team members in Macedonia Total number of trips of Macedonian team members to Austria (days and/or months)</p><p>2/5 Please list all planned trips and stays for 2020 in the following year overview:</p><p>Stays of Macedonian project participants in Austria 2020 according to the rates(=> see announcement)</p><p> duration of stay Number of trips Living cost Name approximate dates / activities (days/ months) to Austria in Austria in EUR</p><p>TOTAL </p><p>Trips of Austrian project participants to Macedonia 2020</p><p> duration of stay Number of trips Travel expenses Name approximate dates / activities (days/ months) to Macedonia in Macedonia</p><p>TOTAL </p><p>Total cost for trips and stays requested in 2020:</p><p>Total visits and stays financed by the Austrian side in 2020</p><p>Calculated total costs Total stays of Macedonian team for 2012 in EUR Total number of trips of Austrian team members in Austria (days and/or Living costs in Austria+ travel costs to members to Macedonia months) Macedonia (max. EUR 3.000,- per year)</p><p>Living costs in Macedonia + travel costs to Austria (max. EUR 3-5.000,- per year</p><p>Total visits and stays financed by the Macedonian side in 2020</p><p>Total stays of Austrian team members in Macedonia Total number of trips of Macedonian team members to Austria (days and/or months)</p><p>3/5 Are there any plans for further continuation of this project co-operation (in particular research programs of the EU)?</p><p>YES, indicating the program: NO</p><p>Is there interest in extending the project co-operation to other countries?</p><p>YES, to: NO</p><p>Have you ever participated on projects supported by WTZ with Macedonia? When? Which partner institution?</p><p>Project Nr.: </p><p>Year (duration) </p><p>Partner institution: </p><p>Please check your branch of science</p><p>Natural Sciences Technical Sciences Medicine Agriculture and Forestry including Veterinary Medicine Social Sciences Humanities</p><p>4/5 CHECKLIST for attachments: On Macedonian side the entire project proposal submitted in original plus one electronic copy via email have to be submitted: Application form Curricula vitae et studiorum of all project participants list of relevant publications in the past 2 years Project description including the methods section (3 to 5 A4 pages) brief description of the partner institute brief description of the tasks of project participants within the project</p><p>Please ensure that you project partner did submit a proposal in Austria as well. One-sided submissions can not be considered!</p><p> on signature</p><p>Please submit the entire project proposal in two original (Deadline: 31.12.2017– date stamp) to: Ministry of Education and Science Department for Science and Technological Development Ul. Sv.Kiril i Metodij, 5, 1000 Skopje Telephone: ++389 2 3140 185, 076 485 081 Fax: ++389 2 3118 414 , 3118 630 Email: [email protected] Internet: www.mon.gov.mk</p><p>5/5</p>