Application form scientific research

"(Required)" indicates required fields

1Personal Info

2Research info

3Participants

4Budget

5Literature

6Sign

7Confirm

This application form is open from 1 august until 15 october

Currently this application form is only available in English, we are working on a dutch translation. If you want, you can fill in the fields in Dutch.

Please select the funding source you wish to apply for(Required)

De Cock-Hadders Foundation funding for scientific research

Preferred language for correspondence(Required)

Nederlands

English

Name(Required)

Name Surname

Email address(Required)

Enter email address Confirm email address

P-number(Required)

Position (including source of funding)(Required)

Start date of PhD project(Required)

MM slash DD slash YYYY

End date of PhD project(Required)

MM slash DD slash YYYY

Research group

(Primary) department(Required)

Name of your department(Required)

Internal UMCG postcode(Required)

(Short) Title of the project(Required)

Overall objective of your PhD project(Required)

Overall description of the project including scientific background(Required)

Detailed work plan for the period for which financial assistance is requested(Required)

Location and availability of research facilities and other facilities(Required)

Main participants in the project

Mention also your supervisor(s) max 6.

Name, title and affiliation (department)(Required)

Task(s) in the project(Required)

Hours contribution per week(Required)

Supervisor - Name, title and affiliation (department)(Required)

Supervisor - Task(s) in the project(Required)

Supervisor - Hours contribution per week(Required)

Add extra participants

Name, title and affiliation (department) 3

Task(s) in the project 3

Hours contribution per week 3

Name, title and affiliation (department) 4

Task(s) in the project 4

Hours contribution per week 4

Name, title and affiliation (department) 5

Task(s) in the project 5

Hours contribution per week 5

Name, title and affiliation (department) 6

Task(s) in the project 6

Hours contribution per week 6

Name, title and affiliation (department) 7

Task(s) in the project 7

Hours contribution per week 7

Name, title and affiliation (department) 8

Task(s) in the project 8

Hours contribution per week 8

Name, title and affiliation (department) 9

Task(s) in the project 9

Hours contribution per week 9

Name, title and affiliation (department) 10

Task(s) in the project 10

Hours contribution per week 10

Budget

Overall budget for consumables, specified according to sources and years (calendar years, not academic years)

Item(Required)

Price(Required)

Detailed specification(Required)

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Price

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Detailed specification

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Detailed specification

Literature: recent publications from the applicant relevant for the present project (submitted, in press, published, conference presentations)(Required)

Literature from your research group: relevant for the present application and not given in the previous box (max. 10*)(Required)

Other relevant publications

Have you applied for a grant from the De Cock-Hadders Foundation in the last four years?(Required)

Title of the project(s) + year of application

If you have applied for more than 1 project, please fill in al the projects where you applied to. Each project on a new line.

Was it awarded?

Name applicant(Required)

Date(Required)

MM slash DD slash YYYY

Applicant's signature(Required)

Drop files here or

Max. file size: 64 MB, Max. files: 1.

Name of supervisor(Required)

Date(Required)

MM slash DD slash YYYY

Signature, preferably by a letter of approval(Required)

Drop files here or

Max. file size: 64 MB, Max. files: 1.

* As an alternative to an electronic signature from your supervisor, you can include a copy of a letter signed by your (primary) supervisor in which (s)he states that (s)he has read your application and has approved the content. Please upload the copy to the box above, before the Hora Finita statement.

Include a print screen or other copy of your Hora Finita Dashboard showing registration and progress of your project(Required)

Drop files here or

Max. file size: 64 MB, Max. files: 1.

Terms and conditions(Required)

I have completed this form truthfully and agree to the terms and conditions.

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Submitting your request is final. Uploading may take a while, so please be patient and wait untill your application is uploaded successfully

Name

This field is for validation purposes and should be left unchanged.