application form Al Maqdisi EN 2015 17 .pdf



Nom original: application form Al-Maqdisi_EN 2015-17.pdf
Titre: application form Al-Maqdisi_EN 2015-17
Auteur: gharets

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APPLICATION FORM PHC AL MAQDISI 2015 NR °
Al Maqdisi program 2015-2017

1. Partner teams
IMPORTANT: Please contact the coordinators immediately should your contact information change after submission

France

Palestine

France

Palestine

Project leader 1
Name
Laboratory 1
NameAddress:
Zip/area code:
City:
Telephone:
Fax:
Email:
Web site:
Affiliated institution:
Address:
Zip/area code:
City:
Country:
Website:

Project leader 2
Name
Laboratory 2
NameAddress:
Zip/area code:
City:
Telephone:
Fax:
Email:
Web site:
Affiliated institution:
Address:
Zip/area code:
City:
Country:
Website:
1

To be filled by Joint committee

1

1

Al Maqdisi program 2015-2017

Date and signature by the President, the Rector, of the Director of the Institution:
French partner

Palestinian partner

PROJECT BRIEFING
1- Title:

2- Abstract:

3- National and International context (please, detail the implicit hypotheses that are key to the success of the
project):

4- Key words:

2

Al Maqdisi program 2015-2017

PROJECT DESCRIPTION
Please provide an exhaustive description, including the key issue(s)/hypotheses justifying of the
research and the objectives to be achieved (expand table as much as necessary):
Background of the cooperation (list of possible joint publications) & Introduction

Objective (scientific objectives, hypothesis and scientific issue)

Description and methodology

Organization - Research planning

Expected results

List of attached documents

3

Al Maqdisi program 2015-2017

TEAM MEMBERS INVOLVED IN THE PROJECT
Please attach all CVs
Palestinians:
Name

First Name

Specialty

Rank2

Comments

Time allocated to the
project. Estimation/month

Name

First Name

Specialty

Rank3

Comments

Time allocated to the
project. Estimation/month

French:

PR : Professor
MC : Maître de conférence/ Associate Professor
MA : Maître assistant/ Assistant Professor
IG : Engineer
DR : Research director
MR : Maître de recherche/ Research supervisor
TC : Technician
TH : PhD student
CR: Chargé de recherche/ Researcher

2

4

Al Maqdisi program 2015-2017

PALESTINIAN RESEARCH LABORATORY
Organizational chart of the laboratory:

Available equipments:

Local or foreign partners other than French (define their role)*:

* Please attach copies of the agreements

5

Al Maqdisi program 2015-2017

FRENCH RESEARCH LABORATORY
Organizational chart of the laboratory:

Available equipments:

Local or foreign partners other than Palestinian (please define their role)*:

* Please attach copies of the agreements.

6

Al Maqdisi program 2015-2017

PUBLICATIONS
Both teams are encouraged to list five publications they deem significant to their research activities
and directly linked to the project.

Palestinian partners:

French partners:

7

Al Maqdisi programme 2015-2017

DETAILED TIMEFRAME FOR THE IMPLEMENTATION OF THE PROJECT
Duration:
Time
1st semester

Y
E
A
R 2nd semester

In the Palestinian Territories

In France

Mobility

Mobility

Experimentation

Experimentation

Mobility

Mobility

Experimentation

Experimentation

Mobility

Mobility

Experimentation

Experimentation

Mobility

Mobility

Experimentation

Experimentation

1

3rd semester

Y
E
A
R 4th semester
2

8

Observations

Al Maqdisi programme 2015-2017

EXPECTED OUTCOMES

Scientific

On training*

Socio-economic*

In the
Palestinian
Territories

In France

* For possible commercial use of the joint research, please refer to Section 4 of the call for proposals.

9

Al Maqdisi programme 2015-2017

FUNDING
FUNDING EXPECTED FROM THE AL-MAQDISI PROGRAMME
Project title:

French laboratory:

Palestinian laboratory:

SPENDING PLAN
For the Palestinian laboratory:
Number/ duration
Travel

Food, transportation and
accommodation

Consumables

Running costs and small
equipment* (this should not
exceed 60% of the total
amount requested by the
Palestinian laboratory**)

* specify the necessary equipment to be purchased for the completion of the project
** see section 3 of the call for projects

11

Cost

Al Maqdisi programme 2015-2017

For the French laboratory:
Number/ duration
Travel

Food, transportation and
accommodation

Shipping of equipment
France/Palestinian territories

Running costs and small
equipment* (this should not
exceed 20% of the total
amount requested by the
French laboratory**)

* specify the necessary equipment to be purchased for the completion of the project
** see section 3 of the call for projects

12

Cost

Al Maqdisi programme 2015-2017

OTHER FUNDING
Total funding requested from the Al-Maqdisi programme
Total funding requested from other bodies
- share of the Palestinian supervising body (University, Institute…)

- share of the French supervising body
- share of the Palestinian laboratory
- share of the French laboratory
- funding from a research institution*

- funding from a multilateral body*

- European funding*

- funding from a local government (municipality, region, etc)*

- contract(s) with one or several private companies*

- other*

Total project budget

* please detail.

13



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