FLAD Grants on Portugal-USA collaborative projects Grant Reference (office use): Grant Application For Basic Project Grant Grant Application For Translational Project Grant
PART A – Administrative Form A.1 – Applicant (PT) Surname: Position/Title: Department/Laboratory: Institution Name: Institutional Address: E-mail: Institutional Contact Surname: Position/Title: E-mail:
First Name: Nationality:
Telephone: First Name: Telephone:
A.2 – Co-Applicant (USA) Surname: Position/Title: Department/Laboratory: Institution Name: Institutional Address: E-mail: Institutional Contact Surname: Position/Title: E-mail:
First Name: Nationality:
Telephone: First Name: Telephone:
Patents I have read and agree to the terms and conditions of FLAD Patent Policy Signatures Applicant:
Date
Signature
Date
Signature
Responsible Portuguese Institution Official: Name Position
PART B – Scientific Project Please use font size 11
B.1 – Title
B.2 - Keywords (up to 5)
B.3 – Abstract (2,000 Characters) What is the innovative idea to be tested?
B.4 – Experimental Approach (2,000 characters) How is the idea going to be tested?
B.5 – Conceptual/Technical Context (2,000 characters) What is the major conceptual or technical hurdle that this project is trying to overcome and how will it be surmounted?
B.6 – Impact (2,000 Characters) What are the major findings expected to achieve and their impact in human health?
B.7 – Collaborative relevance (1,000 characters) How is the collaboration important for the execution of the project?
B.8 – Schematic Abstract (up to 1 page)