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Australia-China Science and Research Fund Joint Research Centres Application Form
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Australia-China Science and Research Fund Joint Research Centres Application Form
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Australia-China Science and Research Fund Joint Research Centres Application Form
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Instructions

Australia-China Science and Research Fund Joint Research Centres Application Form
Applications may be submitted at any time up until .
Please save your form regularly. Fields marked with  * are required.
About the Australia-China Science and Research Fund Joint Research Centres
Joint Research Centres (JRCs) are a component of the Australia-China Science and Research Fund (ACSRF). The ACSRF supports the Australian and Chinese Governments’ commitment to support strategic science, technology and innovation collaboration of mutual benefit to Australia and China. JRCs are virtual centres that link Australian and Chinese research institutions conducting a range of research-related activities in a specified field of research. JRCs enable a concentration of effort and achievement of outcomes beyond that of individual research projects.
Completing this form
Please read the Program Guidelines before completing this application form.
Disclosure of information
The Commonwealth’s use and disclosure of your information (provided in this application or otherwise) is set out in the Australia-China Science and Research Fund Joint Research Centres Program Guidelines.
Google Places
The address search fields in this form use Google Places to help fill in the address details. By using this feature you agree to be bound by Google’s Terms of Service and are subject to Google’s Privacy Policy.
Getting help
If you require assistance completing this application form please contact us on 13 28 46 or at business.gov.au. Our website and staff can help you with forms, finding business information and services and allow you to provide feedback, comments or suggestions. You should also read and understand the Program Guidelines and sample grant agreement before completing an application. View these documents at business.gov.au.
Requirements
This form functions best when it is completed using the most recent version of your internet browser. This form is not compatible with Internet Explorer 8 or earlier browsers. If you are using an earlier browser version, you may have difficulty in displaying the form correctly or it may not display at all.
Important information
Save regularly. Click the 'Save for Later' button regularly while completing this form to ensure the information entered is saved. Saved forms will be retained for a maximum of 60 days. If you do not save or submit your form within this timeframe, you will need to start a new form.This form has a tracking code displayed in the top right corner. Please make a note of this tracking code for your records. The tracking code is required to reopen your saved form and you will need to provide this code if you require assistance with your form.Do not use your internet browser's 'back' or 'refresh' buttons as this will cause the form to close and any unsaved information will be lost. Navigate between sections of the form by using the tabs at the top of the form or by clicking 'Continue' or 'Go Back' at the bottom of each page.
Sharing the form
The form can be viewed by more than one person by sharing the form's unique tracking code. However, sharing the form increases the risk of losing unsaved information. The reason for this is that only one person at any one time has saving permission for the application form. If the form is shared, save regularly as the last person that accesses the form has the saving permission. It is recommended that the form tracking code is not shared widely so as to avoid inadvertent loss of information.
Attachments
All attachments marked as required must be attached before your application can be submitted. Files with ".pdf, .rtf, .doc, .docx, .xls, .xlsx, .xlsm" extension types can be uploaded. Total file size of all attachments in the application should not exceed 20MB. Please note that there is a size limit of 2MB per attachment.
Submitting your form
Applications may be submitted at any time up until . You will be provided with a receipt to confirm that your submission has been successful. Please keep this receipt for your records by using the “Download the form and receipt” link or by emailing yourself a copy of the receipt and submission. Both of these options are available in the “To keep a copy of the completed form” box on the Submission Complete page. If you have any enquiries relating to submission of your form, you will need to provide your receipt number.

Eligibility

Australia-China Science and Research Fund Joint Research Centres Application Form
Applications may be submitted at any time up until .
Please save your form regularly. Fields marked with  * are required.

Eligibility

This section will help you determine whether you are eligible to apply for the program.
Does your organisation have an ABN?
Is your organisation registered for GST?
Is your organisation one of the following?
All higher education providers listed at Table A and Table B of the Higher Education Support Act 2003 (Cth) or corporate Commonwealth entities, and state and territory government departments or agencies which undertake publicly funded research. You are not eligible to apply if you are a non-Corporate Commonwealth entity.
Do you have a Chinese primary partner who has submitted, or is in the process of submitting, a corresponding application to the relevant Chinese organisation in accordance with any guidelines or instructions issued by the Chinese Ministry of Science and Technology (MOST)?
Do you have an Australian end user or industry partner that can apply the research outcomes?
Do you confirm that the activities for which you are seeking funding are not currently being funded from any other government source or have previously received JRC funding?
If you receive Australian Government funding for your core activities, you will need to demonstrate that the activity you are carrying out for the JRC program is additional to your core activities. If you have received JRC funding in a previous round you are eligible to apply but cannot receive funding for the same activities that have previously been supported.
You are not eligible to apply for the program. Please refer to the Program Guidelines.

Applicant information

Australia-China Science and Research Fund Joint Research Centres Application Form
Applications may be submitted at any time up until .
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Joint application

Joint applications by one or more entities are acceptable, provided you have a lead applicant who is the main driver of the project and is eligible.
Is this a joint application?
The lead applicant must complete this form. If you are unsure of the status of your application as a joint application please contact us on 13 28 46 or at business.gov.au.
Please list all the joint project partner organisations for this application, starting with the lead applicant. If the lead applicant is a trustee of a Trust, enter the Trust’s ABN.
Please enter the ABN of all Australian partners in the joint application and click the Validate button to retrieve your registration details.

You may have a maximum of 10 organisations collaborating on the application including the lead applicant and the Chinese partner. You must include the industry or end user partner here.
You will be required to provide a copy of the Trust documents showing the relationship of the Incorporated Trustee to the Trust.
The entity name refers to the name that appears on all official documents or legal papers. The entity name may be different from the business name.
Your business may have registered one or more business names. If you operate under a business or trading name you can enter alternate name(s) here. If your business or trading name is not listed here select ‘Other’.
If you have not registered your business name but trade under another name enter it here.
Please upload a copy of the Trust documents showing the relationship of the Incorporated Trustee to the Trust
File:
You must attach a letter of support from each of the other organisations involved in the proposal.Each letter of support should include:details of the partner organisationan overview of how the partner organisation will work with the lead organisation and any other partner organisations in the group to successfully complete the projectthe organisation’s financial support (cash and/or in-kind) for the projectan outline of the relevant experience and/ or expertise the partner organisation will bring to the group the roles/ responsibilities the partner organisation will undertake, and the resources it will contribute (if any) details of a nominated management level contact officer.
Refer to section 10.2 of the Program Guidelines for what is required in the letter of support.
Letter of support
File:
Are there international project partners?

International project partners

Please enter details of all international project partners

The Chinese partner is the Chinese organisation with whom you are partnered for this application. You may specify only one Chinese primary partner per application. The Chinese primary partner organisation must submit a JRC application to the relevant Chinese government agency.
You may have a maximum of 10 organisations collaborating on the application including the lead applicant and the Chinese partner.

Primary Chinese partner organisation contact

You must attach a letter of support from each of the other organisations involved in the proposal. Each letter of support should include details of the partner organisation an overview of how the partner organisation will work with the lead organisation and any other partner organisations in the group to successfully complete the project the organisation’s financial support (cash and/or in-kind) for the project an outline of the relevant experience and/ or expertise the partner organisation will bring to the group the roles/ responsibilities the partner organisation will undertake, and the resources it will contribute (if any) details of a nominated management level contact officer. Refer to section 10.2 of the program guidelines for what is required in the letter of support.
Letter of support
File:

Type of applicant

In this section you must indicate what type of entity you operate under. All entities must have an ABN. All entities must be non-tax exempt incorporated organisations.
Select which type of entity your organisation is: *
To be eligible the company must be incorporated in Australia under the Corporations Act 2001, have an ABN and an ACN and be non-tax-exempt.
For trustees applying on behalf of a trust, you must enter the details of the trustee acting in its capacity as a trustee on behalf of a trust.

Applicant details

These details have been populated from the Australian lead applicant details entered above.
You will be required to provide a copy of the Trust documents showing the relationship of the Incorporated Trustee to the Trust.
The entity name refers to the name that appears on all official documents or legal papers. The entity name may be different from the business name.
Your business may have registered one or more business names. If you operate under a business or trading name you can enter alternate name(s) here. If your business or trading name is not listed here select ‘Other’.
If you have not registered your business name but trade under another name enter it here.
Please upload a copy of the Trust documents showing the relationship of the Incorporated Trustee to the Trust
File:

Trust and trustee details

These details have been populated from the Australian lead applicant details entered above.
You will be required to provide a copy of the Trust documents showing the relationship of the Incorporated Trustee to the Trust.
The entity name refers to the name that appears on all official documents or legal papers. The entity name may be different from the business name.
Your business may have registered one or more business names. If you operate under a business or trading name you can enter alternate name(s) here. If your business or trading name is not listed here select ‘Other’.
If you have not registered your business name but trade under another name enter it here.
Please upload a copy of the Trust documents showing the relationship of the Incorporated Trustee to the Trust
File:
You will be required to provide a copy of the Trust documents showing the relationship of the Incorporated Trustee to the Trust.
The entity name refers to the name that appears on all official documents or legal papers. The entity name may be different from the business name.
Your business may have registered one or more business names. If you operate under a business or trading name you can enter alternate name(s) here. If your business or trading name is not listed here select ‘Other’.
If you have not registered your business name but trade under another name enter it here.
Please upload a copy of the Trust documents showing the relationship of the Incorporated Trustee to the Trust
File:

ANZSIC details

What is the applicant’s main business activity under the Australian and New Zealand Standard Industrial Classification (ANZSIC)?
The Australian and New Zealand Standard Industrial Classification (ANZSIC) is a classification system used by government to group data about organisations based on their primary business activity.The ANZSIC codes and titles are available from the Australian Bureau of Statistics (ABS) website.Phone 13 28 46 if you require assistance.

Address details

Provide your organisation street address (Australian head office)
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Your Terms of Use and Privacy Policy must be publicly available. You must explicitly state in your applications Terms of Use that by using your application, users are bound by Google’s Terms of Service. You must notify users in your Privacy Policy that you are using the Google Maps API(s) and incorporate by reference the Google Privacy Policy.
Once you have complied with Google's policy you should hide this note.
Google Places - start entering your address to search Google Places and if found will autofill the fields below. If not found, please enter the address details directly in the fields below.
Country *
Please enter the country’s two letter code. You can find the two letter code by clicking this link to the ISO resource and selecting 'Country codes' above the search field.
Is the postal address the same as the organisation street address entered above?
Provide your postal address
This widget uses Google Places. In order to use it you need to comply with the Google Place API Policy. To summarise

Your Terms of Use and Privacy Policy must be publicly available. You must explicitly state in your applications Terms of Use that by using your application, users are bound by Google’s Terms of Service. You must notify users in your Privacy Policy that you are using the Google Maps API(s) and incorporate by reference the Google Privacy Policy.
Once you have complied with Google's policy you should hide this note.
Google Places - start entering your address to search Google Places and if found will autofill the fields below. If not found, please enter the address details directly in the fields below.
Country *
Please enter the country’s two letter code. You can find the two letter code by clicking this link to the ISO resource and selecting 'Country codes' above the search field.

Website address

Project site address

Will the project’s activities occur solely at the above listed head office address?
A project site address must be a street address, not a postal address.

Site address

This widget uses Google Places. In order to use it you need to comply with the Google Place API Policy. To summarise

Your Terms of Use and Privacy Policy must be publicly available. You must explicitly state in your applications Terms of Use that by using your application, users are bound by Google’s Terms of Service. You must notify users in your Privacy Policy that you are using the Google Maps API(s) and incorporate by reference the Google Privacy Policy.
Once you have complied with Google's policy you should hide this note.
Google Places - start entering your address to search Google Places and if found will autofill the fields below. If not found, please enter the address details directly in the fields below.
Country *
Please enter the country’s two letter code. You can find the two letter code by clicking this link to the ISO resource and selecting 'Country codes' above the search field.

Latest financial year figures

Has the applicant existed for a complete financial year? *

Latest financial year figures

We collect the following data from all applicants across all grant programs. We use this data to better understand your organisation and to help us develop better policies and programs.All amounts in the table below must show a whole dollar value e.g. $1 million should be presented as $1,000,000. The turnover value must be that of the entity that is making the grant application (the ‘applicant’), regardless of whether the entity belongs to a consolidated group for tax purposes.These fields are mandatory and entering $0 is acceptable if applicable. If they clearly do not apply to your organisation you may select not applicable.
FY
Sales revenue (turnover) *
Total revenue from the sale of goods and services, as reported in the applicant’s Business Activity Statement (BAS).
Export revenue *
Total revenue from export sales, as reported in the applicant's Business Activity Statement (BAS).
R&D expenditure *
Expenditure on Research and Development, i.e. creative work undertaken on a systematic basis in order to increase the stock of knowledge, including knowledge of man, culture and society, and the use of this stock of knowledge to devise new applications.
Taxable income *
Taxable income or loss as per the Applicant's Business Income Company Tax Return Form.
Employees, including working proprietors and salaried directors (headcount) *
Number of individuals who are entitled to paid leave (sick and holiday), or generate income from managing the business.
Independent contractors (headcount) *
Number of individuals engaged by the business under a commercial contract (rather than an employment contract) to provide employee-like services on site.

Ultimate holding company

Does the applicant have an ultimate holding company?
You will be required to provide a copy of the Trust documents showing the relationship of the Incorporated Trustee to the Trust.
The entity name refers to the name that appears on all official documents or legal papers. The entity name may be different from the business name.
Your business may have registered one or more business names. If you operate under a business or trading name you can enter alternate name(s) here. If your business or trading name is not listed here select ‘Other’.
If you have not registered your business name but trade under another name enter it here.
Please upload a copy of the Trust documents showing the relationship of the Incorporated Trustee to the Trust
File:

Project details and funding

Australia-China Science and Research Fund Joint Research Centres Application Form
Applications may be submitted at any time up until .
Please save your form regularly. Fields marked with  * are required.

Project title and description

If your application is successful, the details you provide below will be published on the departmental website. Published project details will include: name of the applicant title of the project a description of the project and its intended outcomes amount of funding awarded.
Provide a project title *
Example project title: Australia-China Joint Research Centre in Low Emission Energy Production
Provide a brief project description for publication on our website *
Ensure your project description focuses on your project’s key activities and outcomes. Explain what it is you are going to do and how it will achieve economic, environmental and social benefits for Australia and China. If the application is successful this project description will be used by the Australian Government in published material.Example project description: Researchers from Australian University and Chinese University will work together to develop advanced energy technologies. Results from their research will be used by their Australian industry partner, NextGenEnergy to create new commercial products. Ultimately this collaboration will result in improved energy security, fossil fuel emissions reduction, economic growth and job creation.

Project outcomes

You may attach up to 3 A4 pages for diagrams supporting your project.
Attachment
File:

Priority areas

Select the predominant priority area for your project
Astronomy related technology, including big data New materials in manufacturing Cross-cutting technologies that will de-risk, scale up, and add value to manufactured products
Effective technologies for individuals to manage their own health care Better models of health care and services
Low emission energy production from fossil fuels and other sources New clean energy sources and storage technologies and demand response technologies that are efficient, cost-effective and reliable

Field of research

Please enter at least 1 and up to 3 Field of Research (FoR) codes that are relevant to this project. Use the Australian and New Zealand Standard Research Classification (ANZSRC) codes provided on the ABS website

Field of Research (FoR) Code

Socio-economic objectives

Please enter at least 1 and up to 3 Socio-Economic Objectives that are relevant to this project. Use the Australian and New Zealand Standard Research Classification (ANZSRC) codes provided on the ABS website

Socio-Economic Objectives Code

Key personnel

List the name and roles and attach the CVs of the Research team.
Please upload a maximum of 10 CVs including the Australian Project Manager, Chinese Project Manager and key project personnel in the team. Each CV must be no more than 2 pages in length and contain experience that is most relevant to the project. Use the CV template provided on business.gov.au.

Key personnel

Upload CV
File:

Project plan

You must provide a plan of the project activities you will conduct including timetable and budget for all significant activities.
Project plan
File:

Project milestones and key activities

Provide details on the activities occurring at each milestone and enter the estimated eligible project costs into the table.
Create new milestones as appropriate. The start date of milestone 1 is the expected project start date. The end date of your last milestone activity will be the project end date.

Milestone

Project duration

Grant amount requested

Grant amount sought from the Australian Government (AUD)
Amount must be GST exclusive.

Australian Grant expenditure table

In the table below provide details on how the grant from the Australian Government will be spent on eligible project activities over the life of the project.
Amounts must be GST exclusive. Note, the maximum grant amount is $1 million. All expenditure must be eligible expenditure, please refer to the Program Guidelines.
Cost item
Total

Sub total eligible expenditure
Ineligible costs
Total grant expenditure

Source of funding

Complete the table below to show the eligible cash and in-kind contributions from the Australian collaborating organisations. Amounts must be GST exclusive. Note: the maximum grant amount under the program is $1 million.
The project cannot be funded by this grant in conjunction with any other Commonwealth grant. The total government grant percentage including non-Commonwealth government funding cannot exceed 100%.

Cash & in kind contributions - Australian collaborating organisations

Provide detail on how the applicant and the Australian collaborating organisation's cash and in-kind contributions will be spent on eligible project activities over the life of the project.
Amounts must be GST exclusive. All expenditure must be eligible expenditure, please refer to the Program Guidelines.
Cost item
Total

Sub total eligible expenditure
Ineligible costs
Total Australian Contributions
Upload a letter of support from the lead applicant demonstrating and clearly articulating the organisation's financial support (cash and/or in-kind) for the project, and a commitment to engage in the research collaboration. The supporting documentation provided with your application must confirm and demonstrate your claims. Support for the project may encompass either a financial commitment or an in-kind commitment. In-kind costs must be directly related to costs of delivering the activities of the project and can include salaries of staff for the time they are involved, and other direct costs incurred for the duration of the activity. Indirect costs cannot be included as in-kind contributions.
Letter of support
File:

Other government contribution sources

If a figure greater than $0 was entered in Part c) Other non-Commonwealth Government Funding in the table above, provide details of the other government grant funding.

Contribution source

Your contribution

To describe your funding strategy for the project complete the table below and provide the following attachments.
Fund Type
Amount ($AUD)
Description on the source of funding
Cash flow
Loans
Equity
Other
Total
Please upload the following: Evidence of conditional support from your Board (or if there is no Board, support from the owner or chief executive officer) that the business can complete the project and meet the project costs not covered by grant funding. Evidence to support the project funding strategy.An Accountant Declaration to confirm your business can fund its share of the project costs. You must use the template provided as an Appendix in the Program Guidelines.
Evidence
File:

Applicant bank account details

If your application is successful we will transfer funds directly into your bank account. Provide your relevant bank account details here.

Supportive documents

Examples of supporting documents are equipment supplier quotes, contractor quotes, invoices etc. You do not need to submit these with this application form. However, if your application is successful you will be required to submit these documents before the grant agreement is finalised. You can find more details in the Program Guidelines.

Grant Amount requested from the Government of the People’s Republic of China

Merit criteria

Australia-China Science and Research Fund Joint Research Centres Application Form
Applications may be submitted at any time up until .
Please save your form regularly. Fields marked with  * are required.
To be competitive, you will need to address all the merit criteria in a written proposal attached to your application. We will assess your proposal against each merit criterion using the weighting indicated. The amount of detail and supporting evidence you provide in your proposal should be relative to the project size, complexity and grant amount requested. You should define, quantify and provide evidence to support your answers. Your written proposal must comply with the formatting requirements issued by the department and these are published on business.gov.au The information contained in your application must be consistent with that provided to the Chinese Government by your primary Chinese partner. We will only award funding to applications that score highly against all merit criteria, as these represent best value for money. In addressing the merit criteria, you should have regard to the priority areas of research announced for the funding round available on business.gov.au.

Merit criterion one (30 points)

The scientific merit of the proposed research, including the potential of the anticipated outcome to advance the knowledge base of the discipline, and its likely scientific impact. *
1.Aims and background Describe: the aims and list the specific objectives of the proposed research collaboration in the context of recent international progress in the field of research. Detail how it will relate to, and benefit, work in the field. Refer only to papers that are available to national and international research communities.
2.Significance and innovation Describe: how the proposed activity is significant. the need for the proposed activity to address an important problem. how the anticipated research outcomes will advance the knowledge base of the discipline and/or address the problem.
3.Approach and methodology Outline the conceptual framework, design and methods, and demonstrate that these are adequately developed, well-integrated and appropriate to the aims of the proposed research collaboration.
4.Roles and research capability of personnel Describe: the role, responsibilities and contributions of the Project Managers and other key personnel including the proportion of time each will spend on this activity. the leading-edge research capability of the project’s Australian and Chinese partners which must be demonstrated by evidence of their academic awards and citations as contained in the submitted CVs, and/or other measures of research or innovation excellence. the roles and levels of involvement of other participants, such as technical staff, including the division of work between Australian and Chinese investigators.
Separately in this application form you must attach a Curricula Vitae (CV) for both Australian and Chinese key personnel identified under part 4. There can be a maximum of 10 key personnel listed, including the Australian and Chinese Project Managers. No more than two pages for each person as per the template available on business.gov.au.

5.References A list of research publications cited in support of your claims made against this criterion.

Merit criterion two (30 points)

The ability of the centre to maximise the application and commercialisation of research outcomes.
1.Expected outcomes and benefits resulting from the proposed research Describe: the expected outcomes and the likely impact of the proposed research collaboration including the possible tangible benefits, including: relevance to the end-user partner; and how the research collaboration might result in economic, environmental and/or social benefits for Australia and China.
2.Utilisation of the research outcomes Describe: a clear path to utilisation of the research outcomes of the centre. how the industry or end-user partner will maximise the application and commercialisation of research outcomes. the strategy to maintain the momentum of this collaboration beyond the term of funding, including the expected timeframe.
3.Details of governance and intellectual property arrangements Describe: the governance model. Outline how this will be applied and make it clear to the assessors that a sound governance structure is in place. the intellectual property (IP) arrangements, including use of IP, the proposed ownership of IP generated by the project and strategies for protecting Australia’s interests.

Merit criterion three (20 points)

The contribution of the centre to building enduring Australia-China collaboration in a priority area of research.
Describe: how the collaboration between Australian and Chinese partner organisations is integral to achieving the outcomes of the proposed research project. your strategy to maintain the momentum of this collaboration beyond the term of funding.

Merit criterion four (20 Points)

The capacity, capability and resources of all project partners to manage the JRC and deliver the activities.
1.Roles and research expertise of each project partner including the lead applicant Describe: why these Australian and Chinese partners are the key organisations to be involved in this centre and how the collaboration will be managed. why the program management arrangements are appropriate, including how any issues or risks can be managed to ensure the objectives of the activity can be achieved. the support available from the partners for the centre. the research leadership and management credentials of the project manager and how the team will be managed. how project partners will ensure they collaborate effectively over the course of the project.
2.Project Plan A project plan must be must be included in your written proposal. The plan should be presented as a mature plan ready for implementation, leading towards the overall project objectives and include proposed timelines, milestones and project management arrangements. It will form the basis of the funding agreement between the Australian Government and successful applicants.
3.Cash and in-kind contributions and budget You must provide an indicative budget for the Australian applicant in the Project details and funding section of this form. The budget must detail the eligible expenditure for which JRC funding is sought and any cash or in-kind contributions from the lead organisation and other Australian collaborating organisations.

You cannot duplicate the in-kind support from the applicant or other participants in both budget tables. The supporting documentation provided with your application must confirm and demonstrate your claims. Support for the project may encompass either a financial commitment or an in-kind commitment. In-kind costs must be directly related to costs of delivering the activities of the project and can include salaries of staff for the time they are involved, and other direct costs incurred for the duration of the activity. Indirect costs cannot be included as in-kind contributions. All amounts must be GST exclusive.

Attachments

Provide the following documents: A written proposal addressing the four merit criteria above A list of research publications cited in support of claims made against merit criterion one.
You must follow the formatting requirements for the written proposal. Failure to comply with formatting rules is considered to be a breach of eligibility requirements and as such an application may be deemed ineligible and withdrawn from further peer review.
Written proposal
File:
List of research publications
File:

Supporting documents

Australia-China Science and Research Fund Joint Research Centres Application Form
Applications may be submitted at any time up until .
Please save your form regularly. Fields marked with  * are required.

Supporting documents

Any supporting documentation you would like to attach to the application can be uploaded here. The following restrictions apply to attachments: Total file size of all attachments in the application should not exceed 20MB file size of each attachment cannot exceed 2MB only files with the following file type extensions can be uploaded (.pdf, .rtf, .doc, .docx, .xls, .xlsx) For assistance with any technical issues experienced while completing this application form or attaching documents, please Contact Us. Our website and staff can help you.
If you wish to include additional documents, these should be limited to those directly relevant to, and in support of, your application
File:

Contact details

Australia-China Science and Research Fund Joint Research Centres Application Form
Applications may be submitted at any time up until .
Please save your form regularly. Fields marked with  * are required.

Primary contact

Person authorised to act on behalf of the applicant. (Note: At least one phone number or mobile must be entered and all the remaining fields below are mandatory unless stated otherwise.)