Application Form 2018

Completing this form Please refer to the LanguageLoop Research and Innovation Grants Program guidelines when completing this form.

Word limits have been specified in several parts of this application. Please adhere to these limits.

The decisions on which application/s will receive grants will be made primarily on the content of this application. You are encouraged to be thorough and detailed within the word limits requested. Please answer every question.

Applications for grants must be made using this application form. Please fill it in as a Word file (preferred) rather than trying to do a handwritten response.

Once your application is completed, please convert the file into a PDF for lodgement. If you are unable to produce a PDF, it is acceptable to lodge it as a Word file.

Privacy/confidentiality Applicants’ personal information will be protected according to the LanguageLoop Privacy Policy, which can be read at languageloop.com.au/privacy.

All grant applications will be treated as confidential. Grant recipients will be publicised through various channels, including our website. The results/outcomes of the recipients’ projects may also be publicised at their completion.

How to lodge your application

Completed applications should be sent electronically in PDF (preferred) or Word format to grants@languageloop.com.au by the due date:5.00pm 14 December 2018.

LanguageLoop does NOT require applications to also be lodged in hard copy format. You will receive an email acknowledgement of receipt of your application. If you do not receive an email acknowledgement, please contact us as soon as possible.

Enquiries Enquiries about the grants program or questions about this application form can be addressed to grants@languageloop.com.au

APPLICANT: [Insert your organisation/individual name here]

Part A: Applicant DetailsThis application is made by: □ an organisation □ an individual (delete whichever not applicable)

Applicant Organisation

1. Name2. Department/Branch/Group3. Physical address (including postcode)4. Postal address (including postcode)5. Website address6. Status(delete those not applicable)

□ For profit □ Not-for-profit (please provide evidence of this as appendix)□ Private company □ Public educational institution□ Local government □ Private educational institution□ Community group – incorporated/unincorporated□ Other (please specify)

7. ABN

Applicant Organisation – Contact Person

10. Title (Mr, Mrs, Ms, Dr)11. Name12. Position title13. Telephone numbers

Business: Mobile:

14. Email address15. Alternate contact Name:

Position title:Telephone:Email:

Part A: Applicant Details (continued)

Individual Applicant

1. Title (Mr, Mrs, Ms, Dr)2. Name3. Physical address (including postcode)4. Postal address

2 Application form – Research & Innovation Grants Program

APPLICANT: [Insert your organisation/individual name here]

(including postcode)5. Telephone numbers Business: Mobile:6. Email address7. Website (if applicable)8. ABN (if applicable)

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APPLICANT: [Insert your organisation/individual name here]

Part B: Project Information

1. Provide a brief profile of your organisation and its involvement with/interest in the language services industry. (250 words)

For individuals, please supply details of your relevant background and describe your involvement with and/or interest in the language services industry. (250 words)Expand box as needed for your response.RESPONSE:

2. Describe your proposed project. (500 words) Please include:

Title Purpose/objectives Methodology (how the project will be carried out) Activities to be undertaken

Expand box as needed for your response.RESPONSE:

3. Project timeline (150 words)Expand box as needed for your response.Expected date of commencement:Expected date of completion:Critical dates/stages in the project:

4. What do you believe will be the outcomes of your project? How will you measure them? (250 words)Expand box as needed for your response.RESPONSE:

5. Why do you think this research or project is needed? How will it benefit the language services industry? (250 words)

Expand box as needed for your response.

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APPLICANT: [Insert your organisation/individual name here]

RESPONSE:

6. Innovation is the core element of this grants program. Demonstrate the innovation within your proposal or indicate how your proposal may produce innovation within the industry. (250 words)

Expand box as needed for your response.RESPONSE:

7. Please provide brief profiles (up to 120 words each) of the leaders and any key researchers/ assistants or volunteers who will be involved in your proposed project. (maximum of four profiles)

Expand box as needed for your response.RESPONSE:

8. Detail any other information not covered in previous sections that you believe needs to be taken into consideration when your application is evaluated. (250 words)

Expand box as needed for your response.RESPONSE:

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APPLICANT: [Insert your organisation/individual name here]

Part C: Project Budget

Expenses

1. What is the total cost of the project? $ (GST inclusive)

2. Please provide a breakdown of the expected costs of this project.

Description $

Add extra rows if needed

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APPLICANT: [Insert your organisation/individual name here]

Part C: Project Budget (continued)

Income

3. Grant amount sought in this application $

4. Other sources of funding (including donations and fundraising)

Amount Organisation Confirmed (YES/NO)

$$$$$

Add extra rows if needed

5. Total income including grant sought $

6. Please specify any in-kind contributions (e.g. volunteers’ skills, time and labour) that will be part of your project. (250 words)

Expand box as needed for your response.RESPONSE:

7. Will your project be viable if the unconfirmed sources of funding detailed above do not eventuate? How might you make up the shortfall? (250 words)

Expand box as needed for your response.RESPONSE:

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APPLICANT: [Insert your organisation/individual name here]

Part D: Project Management

1. Demonstrate that you/your organisation/your group have the capability to successfully implement the proposed project to the outline and budget you have provided. (250 words)Expand box as needed for your response.RESPONSE:

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APPLICANT: [Insert your organisation/individual name here]

Part E: Declaration

As part of making this application for a LanguageLoop Research and Innovation Grant, I/we understand that:

LanguageLoop may request further information from me/my organisation as part of its decision-making process, including audited or unaudited financial statements.

Although I/we may be awarded a grant, its final issuance is subject to successful negotiation and signing of a contract based on my/our application and the grants program’s standard contract.

The grant may be paid as one lump sum or as progress payments at the discretion of LanguageLoop.

Australian bank account details for payment of the grant must be provided should I/we be successful in this application.

The funded project will be subject to monitoring, reporting and periodic meetings with LanguageLoop to gauge milestones and progress. Requirements will be specified in the grant contract.

A financial acquittal report will be required at the completion of the project detailing how the grant money was spent.

Any concerns LanguageLoop may have about my/our performance or delivery to contract will be dealt with through processes specified in the program grant contract.

A final written report on the outcomes and a self-assessment of its success and lessons learned will be required at the completion of the project.

LanguageLoop will undertake its own evaluation of the success and outcomes of my/our project. Presentation of results of the project may be required to LanguageLoop /industry stakeholders at

training or information sessions or at a conference/s. There will be some publicity attached to becoming a grant recipient, such as on the LanguageLoop

website and in industry publications and forums. LanguageLoop may refrain from publicity if it can be proven that it would be harmful to successful completion of the project.

Feedback may be requested on an unsuccessful grant application but that this will be supplied at LanguageLoop’s discretion and that LanguageLoop is under no obligation to provide such feedback.

LanguageLoop Board’s decision on grant recipients is final. LanguageLoop will have full rights to IP to publish and promote as they see fit. +

I/we declare that all the details provided in this application are true and correct to the best of our knowledge. I/we understand that giving false or misleading information is a serious offence and could lead to revocation of the grant and a demand for repayment of any sums already advanced or the full amount of the grant.

Signature of person responsible for application (project leader, office bearer, head of department, etc.)

Print namePosition titleDateTelephone Business Mobile

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