邢唷> 欹 bjbj蝷 A玀玀 NN8<4*tMcyyyTTTh*j*j*j*j*j*j*9,.j*TTj*yy*bbbvyyh*bh*bb(h)y@u]屭'|)T**0*)/zZ/ )/)T^b6LTTTj*j*TTT*/TTTTTTTTTN W: Sino Swiss Science and Technology Cooperation Program2010 APPLICATION FORM FOR INSTITUTIONAL PARTNERSHIPS Part 1: General information 1 Basic dataSwiss Institution: Chinese Institution: Intended start-date: Duration (months): I herby confirm that all the information given in this application and the attachments is correct to the best of my knowledge.Place, DateSwiss main applicantPlace, Date Authorization from the Swiss Institution: (Please both print and sign title and name.)Place, Date Chinese main applicantPlace, Date Authorization from the Chinese Institution: (Please both print and sign title and name.) 2 Personal data2.1 Swiss main applicantSurname:First name(s):Title:Academic degree:Date of birth:Gender:Nationality:Employer:Address:Postcode, city:Country:E-mail:Phone number:Fax number:Chinese main applicantSurname:First name(s):Title:Academic degree:Date of birth:Gender:Nationality:Employer:Address:Postcode, city:Country:E-mail:Phone number:Fax number:Swiss and/or Chinese co-applicant(s) (Insert additional tables if necessary.)Surname:First name(s):Title: Academic degree:Date of birth:Gender:Nationality:Institute name/place of work:Address:Postcode, city:Country:E-mail:Phone number:Fax number: Please insert additional tables into the document to list additional co-investigators. 3. Requested funding (1) Funding to be provided by the SSSTC (2): 1st year2nd year3rd yearTOTALAirline tickets (Switzerland to China)Living expenses (3)Workshop(4)TOTAL (CHF) (1) Total budget over CHF 50000 will require special justification. (2) SSSTC will provide funding for expenses incurred in Switzerland only, e.g., living allowances for visitors. (3) Daily allowances and fellowships for visiting scientists (faculty members and students) from China. For more detailed information see "Financial Guidelines for Scientific Exchanges at  HYPERLINK "http://www.global.ethz.ch/stc/china" www.global.ethz.ch/stc/china. (4) Maximum budget allowed: CHF 300/day for 5 days. Please give detailed justification for workshop budgeting. Funding to be provided by the Chinese Partner: 1st year2nd year3rd yearTOTALTravel costsLiving expenses (3)WorkshopTOTAL (CHF) Part 2 - Collaboration plan Summary (max. 1/2 page)Briefly describe the situation that motivates this collaboration, the objectives, the plan for the collaboration, and the expected results of the proposed activities. Please describe the previous collaborations between the institutions or individual professors of the institutions, if any. ObjectivesPlease explain how this collaboration will benefit your institute and what will be accomplished. Partner InstituteWhat is your past contacts (if any) to this institution? How did you make your first contact to this institute? What is the strength of the partner institute? How does it complement yours? Proposed activities Explain in detail the activities you envisage. Describe how the individual tasks and responsibilities will be divided between the institutes involved. Visiting scientistHosting scientistPurpose of visitPeriod & duration of visitI(Insert additional rows if necessary.) OutlooksAssuming that the partnership worked well, what would be the potential follow-up interactions between the institutes? In the best case scenario, what may develop out of this partnership? Is there a long-term plan for this partnership? Ethical, safety and regulatory issuesDoes your proposed work raise ethical, safety or regulatory issues? If yes, how will you deal with it? Please explain in detail. ATTACHMENTSIn addition, please provide for all applicants:Brief curriculum vitae of all applicants. Letter of the Dean, Chair or Head of involved institutes stating support for the proposed activities and certifying that there will be no overhead or other indirect costs charged.  Call for Proposal, SSSTC. May 9, 2008. 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