申请表 Application Form

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1、申请表ApplicationForm2017年度中国科学院-昆士兰合作科学基金Queensland-ChineseAcademyofSciencesCollaborativeScienceFund2017(注：除了项目中文全称需用中文填写以外，其余内容请用英文填写)SECTIONA–APPLICANTDETAILS申请人情况1.ProjectName项目名称(i)Projecttitle(Maximum5words)(ii)Fullprojecttitle中文全称2.CASApplicantOrganisationDetails(theleadCAS-basedparticipant)申请单位

2、情况Organisation(Fullname)ResearchGroup/Laboratory(ifapplicable)StreetaddressPostaladdressPostcode3.CASProjectLeader项目负责人TitleGivenname(s)SurnameGenderMaleFemaleProjectaddressPhoneMobilePostcodeEmail4.CASProjectContact/DivisionofS&TContact项目联系人TitleGivenname(s)SurnameAddressPhoneQ-CASCollaborativeScie

3、nceFundPage7of7MobilePostcodeEmail5.Queenslandapplicantdetails(leadparticipant)昆士兰主申请单位University/Institute/Company(Fullname)Address6.Queenslandleadresearcher昆士兰方面负责人TitleGivenname(s)SurnameGenderMaleFemaleProjectaddressEmail7.CAS-basedprojectpartners参与该合作的其他中科院研究所Organisation(Fullname)LocationOrgan

4、isation(Fullname)Location8.Queenslandprojectpartners参与该合作的其他昆士兰州机构Organisation(Fullname)LocationOrganisation(Fullname)LocationSECTIONB–PROJECTSUMMARY项目摘要1.ExecutiveSummary(PLAINENGLISH)(a)Queensland-ChineseAcademyofSciencestargetedresearchareas目标领域agriculturalbiotechnologyandfoodresearch,includingfo

5、odsafetyhumanhealth:immunologyorneuroscienceenergyQ-CASCollaborativeScienceFundPage7of7(b)Shortdescriptionoftheoverallproject(PlainEnglish,maximum100words)c)Startdateofproject(d)Enddateofproject(maximumTWOyears)(e)Aimsandobjectivesoftheproject(usenon-technicalterms,maximum300words)(f)Outlinethemaine

6、conomic,socialand/orenvironmentaloutcomesoftheprojectthatwillhavebeenachieved(i)attheendoftheproject(ii)infiveyears(iii)inthelong-term(i.e.theimpactoftheproject)(g)Haveyousoughtorobtainedfundingforthisprojectfromanyothersource?Ifsoprovidethenameofthefundingsource,thenameoftherelevantprogram,thestatu

7、sofyourapplicationandtheamountoffundingsought.Q-CASCollaborativeScienceFundPage7of72.ProjectCostandFundingSummaryExchangerateusedforapplicationandallattachmentsA$1:CNY(a)TotalcostofprojectA$Projectfun