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2020 IAP UoM WH Seed Fund

This is a preview of the Seed Fund Application form. When you’re ready to apply, click Fill Out Now to begin.
 

Project Team Details

* indicates a required field.

Purpose

This form should be used for formal application to the Western Health and University of Melbourne Innovation Acceleration Program Proof-of-Concept Fund. 

Instructions

The form should be completed by a joint WH and UoM team in conjunction with University of Melbourne Business Development staff member (BD) of Research, Innovation and Commercialisation (RIC). 

Complete all sections shaded in grey, keeping to the word limit as directed.  Documents may be attached to the application (in PDF format) if further detail is required, and should be referred to by title. 

The form should not be submitted unless the applicant can truly answer “Yes” or not Applicable (“NA”) to all eligibility criteria in the Eligibility Section.

Applicant Details - Lead UoM Researcher

Which academic division are you from?
Which School, Department or Centre are you from?
Must be an email address. 
Must be an Australian phone number. 

Applicant Details - Lead WH Staff Member

Must be an email address. 
Must be an Australian phone number. 

Project Team

List any additional UOM or WH project team members (including staff, students and honorariesto be involved in the project.  

NameUoM/WH

Further Project Details

Where co-developing with another research institution other than UoM and Western Health
Ie. Ethics officer, research office,
Must be a dollar amount. 
Other opportunities * Required
Response required.Response required.