申請(qǐng)表 application form

1、QCASCollabativeScienceFundPage1of6申請(qǐng)表申請(qǐng)表ApplicationFm2017年度中國科學(xué)院年度中國科學(xué)院昆士蘭合作科學(xué)基金昆士蘭合作科學(xué)基金QueenslChineseAcademyofSciencesCollabativeScienceFund2017(注：除了項(xiàng)目中文全稱需用中文填寫以外，其余內(nèi)容請(qǐng)用英文填寫注：除了項(xiàng)目中文全稱需用中文填寫以外，其余內(nèi)容請(qǐng)用英文填寫)SECTIONA–APPLI

2、CANTDETAILS申請(qǐng)人情況申請(qǐng)人情況1.ProjectName項(xiàng)目名稱項(xiàng)目名稱(i)Projecttitle(Maximum5wds)(ii)Fullprojecttitle中文全稱2.CASApplicantganisationDetails(theleadCASbasedparticipant)申請(qǐng)單位情況申請(qǐng)單位情況ganisation(Fullname)ResearchGroupLabaty(ifapplicable)St

3、reetaddressPostaladdressPostcode3.CASProjectLeader項(xiàng)目負(fù)責(zé)人項(xiàng)目負(fù)責(zé)人TitleGivenname(s)SurnameGenderMaleFemalePhoneMobileProjectaddressPostcodeEmail4.CASProjectContactDivisionofS&TContact項(xiàng)目聯(lián)系人項(xiàng)目聯(lián)系人TitleGivenname(s)SurnameAddressPh

4、oneQCASCollabativeScienceFundPage3of6c)Startdateofproject(d)Enddateofproject(maximumTWOyears)(e)Aimsobjectivesoftheproject(usenontechnicaltermsmaximum300wds)(f)Outlinethemaineconomicsocialenvironmentaloutcomesoftheprojec

5、tthatwillhavebeenachieved(i)attheendoftheproject(ii)infiveyears(iii)inthelongterm(i.e.theimpactoftheproject)(g)HaveyousoughtobtainedfundingfthisprojectfromanyothersourceIfsoprovidethenameofthefundingsourcethenameoftherel

6、evantprogramthestatusofyourapplicationtheamountoffundingsought.2.ProjectCostFundingSummaryExchangerateusedfapplicationallattachmentsA$1:CNY(a)TotalcostofprojectA$ProjectfundingCash(b)QueenslleadapplicantQueenslpartners(i

7、fany)(minimumA$75000)A$DSITIfundingsoughtA$125000(c)TotalQueenslcontributionA$(d)CASleadparticipantChinapartners(ifany)(minimumA$75000)A$CASfundingsoughtA$125000(e)TotalChinacontributionA$(vi)(f)TotalfundingfprojectA$SEC