APPLICATION FORM

PLOGEN PROGRAM

2CONFIDENTIAL – Project Title

GENERAL INFORMATIONThe Plogen Program is a regional initiative in Rogaland to support research-based innovation projects leading to the development of new products and services or in other ways making an impact on society. The Program is a key mechanism to elevate technologies from the basic Technology Readiness Level (TRL) 1 – Research, to Technology Optimization (TRL 2-4) and Proof-of-Concept (TRL 4-6). For more information, please visit http://valide.no/plogen-program/

ELIGIBILITY CRITERIAEmployees at the UiS, SUS, NORCE, NIBIO Særheim, NMBU Høyland, HVL Haugesund/Stord and NOFIMA Stavanger can apply for up to 50.000 NOK. The applicant must be employed at the respective research institute throughout the entire project period or in case of students have a valid student status. The underlying intellectual property/concept/idea must be related to the applicant’s research area and area of interest. Or in case of applications from undergraduate and graduate students these eligibility criteria will be assessed on the case by case basis.

EVALUATIONWhen reviewing the application, the research background and anchoring to previous or current research projects will be assessed, as well as the applicant`s commitment to carrying out an innovation project.

The estimated decisioning time is 1-4 weeks depending on when the application is submitted. The applicants will receive the final decision on the 15th of the following calendar month their application was submitted. For example, if you applied anytime in January, you will be notified about the decision on the 15th of February and so on. Please note that during the summer vacation period and in December delays may occur. Please notify Validé upon submitting your application if for any reason the decision-making process needs to be accelerated and we may be able to accommodate such inquiries.

PROJECT INFORMATIONOnce the application is approved, the applicant has 15 days to contact the research institute he/she is employed at and start the project. From that day, the project must be completed, and the final report submitted to Validé within 6 months. In case the project is approved later during the year (Q3 – Q4) and the applicant is not able to complete it within the same calendar year of the project start, both the research institute administration and Validé must be notified in due time.

In any other changes, such as changes with the project timeline, scope, employment status, etc. the research institute and Validé must to be notified as soon as possible. In case of significant changes in project scope, change in employment status or other important factor, the project may be terminated and the funding may be withdrawn.

Please send this application form electronically in a .pdf and .doc format to matyas@valide.no and to plogen@valide.no and name the files as follows: “Name of the applicant, Project Title and Plogen Program 2019”.

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3CONFIDENTIAL – Project Title

Title: Keywords (please provide at least 3 distinguishing keywords unique to your project):

Main Applicant:Name: Phone (Office): Phone (Mobile): E-mail: Workplace(s) and Position(s): Main (..%) Position: 2. (..%) Position: 3. (..%) Position: Department at the Research Institute: Research Group / Institute name:

Technical Area (Please underline one or more of the below and/or add specification under “Other”):

Agriculture Energy Health Technologies Security

Automotive e-Commerce Life Sciences Semiconductors

Aquaculture Educational Technology

Information Technology

Social Networking

Biotechnology Construction Material Science Software

Computer Hardware Financial Services Medical Devices Social Sciences and humanities

Communications Gaming Nanotechnology Transportation

Consumer Electronics Food Physical Sciences Other (please specify):

Short, non-confidential summary of the Invention (maximum 200 words):

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4CONFIDENTIAL – Project Title

1. BACKGROUND Explain what the expected outcome of your research project is, what problem/challenge are you trying to resolve and why is this difficult. Describe your research project, its status, provide an overview of publications (scientific literature, poster, PhD or other thesis, teaching material, etc.) and collaboration projects within academia, industry or the public sector if any. Please list all relevant past and planned activities.

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5CONFIDENTIAL – Project Title

2. INNOVATION CONCEPT Describe the innovation concept and how does that build on your research. What is new in your approach, how will the outcome of your research will make an impact and to whom does this matter? What may be the final form of your innovation concept (ex: software, device, method, questionnaire, app, design, database, system, etc.)?

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6CONFIDENTIAL – Project Title

3. PROJECT PLAN

Describe the goal and anticipated results of this Plogen Project. List all activities and explain through what development steps will your innovation concept be realized beyond this Plogen Project.

List of Activities and Budget

Activity Timeline (from – to) Cost (net amount + MVA) in NOK

1. … MM-MM/YYYY2. … MM-MM/YYYY3. … MM-MM/YYYY

Total1

1 The total budget is 50.000 NOK including VAT at the UiS, SUS, NMBU and HVL and 50.000 NOK not including VAT at the NORCE, NIBIO, Nofima.

Project Team

Name /Position1 Workplace Role in the Project

1 List all project team members. If the name of the person is not yet known, please write what will be the position of this person (ex: PhD student, master student, technician)

Suppliers

Name1 Role in the Project

1 List all companies and research institutes involved and their role in the project.

Attachments (drawings, articles, publications, contracts, etc.):

Nr. Name of the attachment

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