ASRF Proof of Concept Application Form

1. ASRF PROPOSAL APPLICATION FORM
Proof of Concept (POC) Scheme
Revision 2.0,
Jan. 2012

2. TABLE OF CONTENTS
1. Introduction and Funding Conditions ........................................................................................................3
Acknowledgement..........................................................................................................................................5
2. Summary ....................................................................................................................................................6
Title of the project proposal ................................................................................................................................ 6
Project Acronym ................................................................................................................................................. 6
Project summary/Abstract................................................................................................................................... 6
Project team ........................................................................................................................................................ 6
Classification of the proposal / project field ........................................................................................................ 7
Proposal keywords ............................................................................................................................................. 7
Funding/support and duration summary ............................................................................................................. 7
3. Concept and Objective ...............................................................................................................................8
Background ......................................................................................................................................................... 8
Concept and statement of the problem .............................................................................................................. 8
Objectives ........................................................................................................................................................... 8
Expected outcomes and the value to the users/customers ................................................................................ 9
4. State-of-the-art (Optional) .......................................................................................................................10
Literature research............................................................................................................................................ 10
Patents research ............................................................................................................................................... 10
5. Implementation and methodology plan ....................................................................................................11
6. Financial request and justification ...........................................................................................................12
7. Market Potential .......................................................................................................................................13
Target Customers and value ............................................................................................................................ 13
Market position (local and global) ..................................................................................................................... 13
Commercialization/sales plan ........................................................................................................................... 13
8. Contact details ..........................................................................................................................................14
9. Certification..............................................................................................................................................15
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3. 1. Introduction and Funding Conditions
Applied Scientific Research Fund (ASRF) is an Arabic non-government, non-profit organization,
created by Samih Darwazah, founder of Hikma Pharmaceuticals, to foster and enable innovation
through various funding schemes for applied researches and commercialization activities as well as to
create the culture of research and innovation in the Arab region.
 Funding scheme objectives:
◦ Support the development and/or testing of Prof of Concept (POC) or prototypes, for
Jordanian organizations
◦ Accelerate the commercialization process by demonstrating prototypes to potential
customers, partners or funders.
 Eligibility:
◦ Researchers and inventors in Jordan
◦ Research centers and universities
◦ Jordanian organizations (including firms) interested to develop their R&D prototypes
◦ Jordanian university students in both the bachelors and masters levels
◦ Note: For universities with Technology Transfer offices it is highly recommended that
application be endorsed by the office manager
 Conditions to be a candidate project:
◦ Technical feasibility of the project
◦ Market potential and feasibility of the product or service developed
◦ Clear, tangible and measurable outcomes
◦ Impact and quality of the project
◦ University supervisor commitment to the project (where the applicants are students)
 ASRF’ Support (up to 10,000 JD over 1 year) that can include::
◦ Technical Development of the Proof of Concept (POC)
◦ Prototype design and development
◦ Full lab-scale demonstration
◦ Material and implementation costs
◦ Technical and prototype testing
◦ Specialist testing, verifying applications and conducting field studies
◦ Demonstration to potential customers
◦ POC marketing testing (with customers)
◦ Transportation to the customers
◦ Development of business case / show case with potential customers
◦ Development of simulations or models are NOT supported unless the technology is related
to those fields (e.g. the fund will not support the simulation of motors, it will support the
development of the prototype of the motor, yet the simulation results should be available in
advance)
 Intellectual Property ownership:
◦ The inventor FULLY owns their IP - ASRF has no ownership.
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4. ◦ ASRF receives a royalty (% of sales) in the first five years. (as agreed by both inventor and
ASRF up front)
 Contribution to ASRF and /or the community:
◦ The team agrees to provide technical reports and progress on their project at regular
predefined intervals (quarterly every 3 months) based on the support/funding agreement.
◦ The team agree to deliver public training/workshops on their technical field of expertise as
it relates to the developed POC that is equivalent to 1 day public workshop/training
◦ Supporting ASRF activities or ASRF beneficiaries by providing total of 6 working hours
by providing technical consulting or access to customers/market to ASRF or its
beneficiaries.
◦ Agreeing to press and promotion as part of the ASRF marketing and communication
campaign, with teams prior approval of content.
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5. Acknowledgement
The Applied Research Fund (ASRF) team shares special thanks to the advisory panel for their valuable
contribution to this form.
Advisory Panel for POC
Suleiman Shannak
TareK Al-Qasim
Scott Gillespie
Farhan Kalaldeh
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6. 2. Summary
Title of the project proposal
Concise & descriptive title (No more than 20-25 words)
Project Acronym
(Select a short name for your project to simplify the communication with ASRF)
Project summary/Abstract
(200 words max)
Provide a clear and concise summary of the proposed Proof of Concept Project including what elements
make the project innovative
Project team
Maximum 3 main members preferably own the IP (Intellectual Property) to be developed.
Research team
Team Member Name Title/Position Institute1
Coordinator
Member 1
Member 2
Note1: The coordinator must be affiliated with the organization that will administer the grant
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7. Classification of the proposal / project field
Classify your proposal under each of the following areas. (Multiple fields can be selected but indicate the
main field with “M”)
Acronym Scientific Area Field Selection
AF Agriculture, Food and Fisheries Sciences
BT Biotechnology
CI Chemical Industries
DM Drugs & Medicines
EE Electrical & Electronics Technologies
EG Energy (including renewable energies)
EN Environment, (including Climate Change)
HE Healthcare
IT Information and Communication Technologies
MC Mechanics & Construction
NN Nanosciences, nanotechnologies, materials & new
production technologies
NS Natural / Pure science
SE Security and Safety
SH Socio-economic Sciences and the Humanities
TT Transport & logistics
WA Water, Waste & Utilities
OT Other: Please specify
Proposal keywords
To facilitate selection of evaluators / indexing / promotion/ etc
Funding/support and duration summary
Requested fund amount (in JOD)
(up to 10000)1
Project duration (in Months)
(up to 12) 1
Note1: Justification must be provided for requested funds more than 10000 JOD or more than 12 Months and will be subject
for approval by the fund management and the evaluation committee
Co-funding/ other funding resources
Is this research proposal co-funded by other agency? If yes please attach the funding agreement and the
proposal (will be considered in the evaluation)
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8. 3. Concept and Objective
Background
Provide a basic background and relevant information about your project.
Provide a basic but thorough introduction to your subject. Don‟t expect reviewers to be familiar with
your field so you should include clarifying information for your project. Reviewers are an intelligent, yet
diverse audience. State your overall vision and motivating rationale. What is lacking? Provide
background and need/significance. Do you have preliminary results? Pictures, videos, images help.
(1/2 page max)
Concept and statement of the problem
What are the problems you are trying to solve? and for whom?
How are such problems treated with existing technologies/solutions currently?
(1/2 Page max)
Objectives
What are the project‟s goals?
What are you trying to prove with the POC?
Who will you demonstrate the POC to?
When will you be able to demonstrate your POC to prospects, partners, potential investors?
(1/2 Page max)
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9. Expected outcomes and the value to the users/customers
Who are the target customers / beneficiaries?
What tangible outcome are you driving for with the POC? What are the expected outcomes?
What are the values, benefits and impact of the project on the target beneficiary?
How does your solution improve your products quality, productivity or reduce cost or fill a gap in the
market?
(1/2 Page max)
Current stage of development
Describe the current stage of development of the invention/technology.
What experiments did you conduct to validate your concepts?(attach the results reports/summary)
Did you develop models or simulations for this concept? (attach the results reports/summary)
(1/2 Page max)
Intellectual Property (IP) position
Have you registered IP for the project? Please provide summary information
What are the steps you are considering for the IP protection, management and strategy?
Will any new IP be developed during this project?
(1/2 Page max)
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10. 4. State-of-the-art (Optional)
Literature research
State recent literature with defining what has been done and what is needed.
References related articles, research, market activities related to your project.
You can attach more details
(1/2 page max)
Patents research
State published patents related to this project
(You can use the following links for patents search)
http://www.google.com/patents
http://www.wipo.int/pctdb/en/
http://www.epo.org/searching.html
http://patft.uspto.gov/
http://ipco-jo.org
(1/2 page max)
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11. 5. Implementation and methodology plan
Explain the methodology and procedure of your project
Describe the project activities (experiments) or tasks you are going to follow to implement the
project
(1/2 page max)
Tasks and timeline
List the tasks/activities you are going to follow and the expected deadline to achieve them.
Maximum 5 main tasks/activities
Please mark with „X‟ the months you will work on each task or activity
Note that you have to provide a progress report to ASRF every 3 or 6 months based on the
funding agreement
Months (deadlines)
Tasks/activities 1 2 3 4 5 6 7 8 9 10 11 12
Task1
Task2
Task3
Task 4
Task 5
Technical and management expertise
Outline the relevant technical and managerial expertise of the project team
Describe the track record of the team in similar project/field
Please attach the CVs of the team members
(1/2 page max)
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12. 6. Financial request and justification
Proof of Concept Budget
Item Amount Justification
Material / Consumables1
Transportation
Testing
Services
Others
Note1: specify the material and its quantities
Co-funding/ other funding resources
Is this proposal co-funded (or applied for other funding) by other agency? If yes please attach the funding
agreement and the proposal (will be considered in the evaluation)
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13. 7. Market Potential
This section should be completed in cooperation with the Technology Transfer officer if the applicants are
from university that has such an office and the officer signs off on Section 9 as well.
Target Customers and value
Who are the target customers / users /beneficiaries?
What are the values delivered for the customer/user? (What is the added value to the
customers/users)?
What are the benefits for them from adopting your technology?
What organization are you targeting to demonstrate your proof of concept to?
(1 page max)
Market position (local and global)
Explain the potential market and demand for the product and estimated market size: (Please
provide/attach supporting data)
Explain competition/alternative products/technologies to the proposed innovation
Who are the major companies in the technological area of this innovation?
(1 page max)
Commercialization/sales plan
Outline how you will commercialize the project outcomes
How will this fund assist the commercialization of the invention / technology?
How does the fund will/can support future sales and generate revenues?
What is the likely size of future sales? and when?
Which countries you are targeting the sales? Local or global?
(1 page max)
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14. 8. Contact details
Member 1 Contact Details
Person
First Name
Last Name
University
Address
Mobile Phone
Email
Web
Member 2 Details
First Name
Last Name
University
Address
Mobile Phone
Email
Web
Member 3 Details
First Name
Last Name
University
Address
Mobile Phone
Email
Web
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15. 9. Certification
In submitting this research proposal, we confirm that:
The information in the proposal submitted is true and complete.
The students team is responsible to report the achievements and results to ASRF
The students team will participate in the community work with ASRF
Name Signature Date
Coordinator
Team Member 1
Team Member 2
Tech Transfer Officer (if
available)
Applied Scientific Research Fund (ASRF)
 Email: info@asrf.jo
 Tel: +962-6-515-5095
 Fax: +962-6-516-1399
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