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![Application Form
Erasmus+
Call: 2014
KA2 – Cooperation and Innovation for Good Practices
Project summary
Please provide a short summary of your project. Please recall that this section [or part of it] may be used by the European
Commission, Executive Agency or National Agencies in their publications. It will also feed the Erasmus+ dissemination platform.
Be concise and clear and mention at least the following elements: Context/background of project; objectives of your project; number
and profile of participants; description of activities; methodology to be used in carrying out the project; a short description of the
results and impact envisaged and finally the potential longer term benefits.
In view of further publication on the Erasmus+ dissemination platform, please be also aware that a comprehensive public summary
of project results will be requested at report stage(s). Final payment provisions in contract will be linked to the availability of such
summary.
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Form hash code:
AF
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Please provide a translation in English.
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- 1. Application Form -Call: 2014 KA2 – Cooperation and Innovation for Good Practices Erasmus+ Strategic Partnerships for Higher Education General Information - Context: this section asks for general information about the type of project proposal you want to submit; - Context: this section asks for general information about the type of project proposal you want to submit and about the Agency that will receive, assess and select your proposal; - Participating organisation(s): this section asks for information about the applicant organisation and about other participating organisations involved as partners in the project; - Description of the project: this section asks for information about the stages of the project which should include: preparation, implementation and follow-up; - Budget: in this section you will be asked to give information about the amount of the EU grant you request; - Project Summary: In this section you should describe in a compact way your project's rational, objectives and how you intend to achieve these; - Check List/Data Protection Notice/Declaration of Honour: in these sections, the applicant is made aware of important conditions linked to the submission of the grant request; - Annexes: in this section, the applicant needs to attach additional documents that are mandatory for the completion of the application. - Submission: in this section, the applicant will be able to confirm the information provided and to submit the form electronically. D For more information on how to fill in this application form, you can read the e-Forms Guideline. Context Key Action Action Erasmus+ AF R Programme Cooperation and Innovation for Good Practices Strategic Partnerships Field Strategic Partnerships for Higher Education Call 2014 Round 1 Deadline for Submission (dd-mm-yyyy hh:nn:ss - Brussels, Belgium Time) 30-04-2014 12:00:00 T Round Language used to fill in the form Project Identification Project Title Project Acronym Project Start Date (dd-mm-yyyy) Project Total Duration (Months) Project End Date (dd-mm-yyyy) Applicant Organisation Full Legal Name (Latin characters) Form hash code: Validate
- 2. Application Form Erasmus+ Call: 2014 KA2– Cooperation and Innovation for Good Practices Form hash code 0000000000000000 National Agency of the Applicant Organisation Identification For further details about the available Erasmus+ National Agencies, please consult the following page: http://ec.europa.eu/education/participant-portal/support/contact/index_en.htm T AF R D Form hash code: Validate
- 3. Application Form Erasmus+ Call: 2014 KA2– Cooperation and Innovation for Good Practices Participating organisation(s) Applicant Organisation Check PIC PIC Full legal name (National Language) Full legal name (Latin characters) Acronym National ID (if applicable) Department (if applicable) Address Region AF R P.O. Box D Country Post Code CEDEX City Website T Email Telephone 1 Telephone 2 Fax Profile Type of Organisation Is your organisation a public body? Is your organisation a non-profit? Accreditation Have you received any type of accreditation before submitting this application? Accreditation Type Form hash code: Accreditation Reference Validate
- 4. Application Form Call: 2014 Erasmus+ + KA2– Cooperation and Innovation for Good Practices - Background and Experience Please briefly present your organisation (e.g. its type, size, scope of work, areas of specific expertise, specific social context and, if relevant, the quality system used). What are the activities and experience of your organisation in the areas relevant for this project? What are the skills and/or expertise of key persons involved in this project? D Have you participated in a European Union granted project in the 3 years preceding this application? EU Programme + - Legal Representative Year Project Identification or Contract Number Applicant/Beneficiary Name T Title AF R Please indicate: Gender First Name Family Name Department Position Email Telephone 1 If the address is different from the one of the organisation, please tick this box Address Form hash code: Validate
- 5. Application Form Erasmus+ Call: 2014 KA2– Cooperation and Innovation for Good Practices Country Region P.O. Box Post Code CEDEX City Telephone 2 Contact Person Title First Name Department Position Email Telephone 1 AF R Family Name D Gender Address Country T If the address is different from the one of the organisation, please tick this box Region P.O. Box Post Code CEDEX City Telephone 2 Form hash code: Validate
- 6. Application Form Erasmus+ Call: 2014 KA2– Cooperation and Innovation for Good Practices Partner Organisation Check PIC PIC Full legal name (National Language) Full legal name (Latin characters) Acronym National ID (if applicable) Department (if applicable) Address Country D Region P.O. Box AF R Post Code CEDEX City Website Email T Telephone 1 Telephone 2 Fax Profile Type of Organisation Is the partner organisation a public body? Is the partner organisation a non-profit? Accreditation Has the partner organisation received any type of accreditation before submitting this application? Accreditation Type + Form hash code: Accreditation Reference Validate
- 7. Application Form Call: 2014 Erasmus+ KA2– Cooperation and Innovation for Good Practices Background and Experience Please briefly present the partner organisation (e.g. its type, size, scope of work, areas of specific expertise, specific social context and, if relevant, the quality system used). What are the activities and experience of the partner organisation in the areas relevant for this project? What are the skills and/or expertise of key persons involved in this project? Has the partner organisation participated in a European Union granted project in the 3 years preceding this application? D Please indicate: + - Legal Representative Title First Name Year Applicant/Beneficiary Name T Gender Project Identification or Contract Number AF R EU Programme Family Name Department Position Email Telephone 1 If the address is different from the one of the organisation, please tick this box Address Country Form hash code: Validate
- 8. Application Form Erasmus+ Call: 2014 KA2– Cooperation and Innovation for Good Practices Region P.O. Box Post Code CEDEX City Telephone 2 Contact Person Title Gender Family Name Position Email Telephone 1 AF R Department D First Name If the address is different from the one of the organisation, please tick this box T Address Country Region P.O. Box Post Code CEDEX City Telephone 2 Add Partner Form hash code: Remove Partner Validate
- 9. Application Form Erasmus+ Call: 2014 KA2– Cooperation and Innovation for Good Practices Description of the Project What is the rationale, issues and needs to be addressed by this project? In what way is the project innovative and/or complementary to other projects already carried out? How did you choose the project partners and what experiences and competences will they bring to the project? How was the partnership established and does it involve organisations that have never been previously involved in a similar project? AF R D How will cooperation and communication happen among all project partners and with other relevant stakeholders? What will be the purpose and frequency of the transnational project meetings and who will participate in them? What are the most relevant priorities addressed by your project? - T + What are the most relevant topics addressed by your project? + - What results are expected during the project and on its completion? Please provide a detailed description of the expected results (if they are not listed in intellectual outputs, multiplier evens or learning, training, teaching activities). Form hash code: Validate
- 10. Application Form Erasmus+ Call: 2014 KA2– Cooperation and Innovation for Good Practices Preparation Please describe what will be done in preparation by your organisation and by your partners before the project activities take place. Project Management How will you ensure proper budget control and time management in your project? AF R D How will the quality of the project's activities and results be monitored and evaluated? Please mention the involved staff profiles and frequency of such quality checks. What measures are foreseen to handle project risks (e.g. conflict resolution processes, etc.)? T Which activities and indicators of achievement (quantitative and qualitative) will you put in place in order to assess whether and to what extent, the project reaches its objectives and results? Implementation Please describe briefly how you intend to organise your project's activities. What target groups do you address in your activities plan? Form hash code: Validate
- 11. Application Form Erasmus+ Call: 2014 KA2– Cooperation and Innovation for Good Practices Involvement of Participants With Fewer Opportunities Does your project involve participants facing situations that make their participation more difficult? How many participants (out of the total number) would fall into this category? How will you support these participants so that they will fully engage in the foreseen activities? Which types of situations are these participants facing? - T AF R D + Form hash code: Validate
- 12. Application Form Erasmus+ Call: 2014 KA2– Cooperation and Innovation for Good Practices Project Activities Intellectual Outputs Add Output Remove Output Multiplier Events Add Event Remove Event Learning/Teaching/Training Activities Do you foresee the inclusion of learning, teaching or training activities in your project? What is the added value of these learning, teaching or training activities with regards to the achievement of the project objectives? D Please describe each of the learning, teaching or training activities you intend to include in your project: Follow-up Impact AF R Add Activity Remove Activity What is the expected impact on the participants, participating organisations, target groups and other relevant stakeholders? T What is the desired impact of the project at the local, regional, national, European and/or international levels? How will you measure the previously mentioned impacts? Dissemination and Use of Projects' Results You are requested to elaborate dissemination plans. Please provide answers to the questions below. Form hash code: Validate
- 13. Application Form Erasmus+ Call: 2014 KA2– Cooperation and Innovation for Good Practices To whom will you disseminate the project results inside and outside your organisation? Please define in particular your target audience(s) at local/regional/national/EU level and motivate your choice. Who will be responsible for the dissemination activities within your partnership and which specific expertise has it in this area? How many resources will you make available to allow for the proper implementation of your dissemination plans? What kind of dissemination activities do you intend to carry out (relevance) and through which channels? AF R D How will you ensure that the project's results will remain available and/or will be used by others? If relevant, please provide any other meaningful information deemed necessary to give a comprehensive overview of your dissemination plans. T Sustainability What are the activities and results that are planned to be maintained after the end of the EU funding including the needed resources to sustain them? Form hash code: Validate
- 14. Application Form Call: 2014 Erasmus+ KA2– Cooperation and Innovation for Good Practices Budget For further information please consult the Programme Guide for the overview of funding rules. Please note that all amounts must be expressed in Euros. Project Management and Implementation PIC of Organisation Role of Organisation Name of the Organisation Grant Requested 1.00 D Total PIC of Organisation Total No. of Meetings Total No. of Participants Distance Band T AF + R NOTA BENE: AS DETAILED IN THE PROGRAMME GUIDE, IN CASE OF PROJECTS INVOLVING MORE THAN 10 PARTICIPATING ORGANISATIONS, THE GRANT SUPPORT FOR PROJECT MANAGEMENT AND IMPLEMENTATION WILL BE LIMITED TO THE AMOUNT EQUIVALENT TO 10 PARTICIPATING ORGANISATIONS (1 COORDINATING AND 9 PARTNER ORGANISATIONS) FOR THE PROJECT DURATION. Transnational Project Meetings - Grant per Participant Grant Requested Total NOTA BENE: AS DETAILED IN THE PROGRAMME GUIDE, THE GRANT SUPPORT FOR TRANSNATIONAL PROJECT MEETINGS WILL BE LIMITED TO A MAXIMUM AMOUNT OF 23.000 € PER PROJECT PER PERIOD OF 12 MONTHS. FOR SHORTER PROJECT DURATIONS, THE MAXIMUM AMOUNT WILL BE REDUCED PROPORTIONALLY TO THE ACTUAL PROJECT DURATION IN NUMBER OF MONTHS. Intellectual Outputs Which concrete participating organisations' staff resources are you planning to use in the production of outputs that have a significant contribution in terms of potential impact and transferability (e.g. new curricula, pedagogical materials, IT Tools, analysis and studies, etc.)? PIC of Organisation Output Identification Category or Staff No. of Working Days Country Total + Form hash code: Grant per Day Grant Requested Total - Validate
- 15. Application Form Call: 2014 Erasmus+ KA2– Cooperation and Innovation for Good Practices Multiplier Events Event Identification PIC of Organisation No. of Local Participants Total + Grant per Local Participant No. of Foreign Participants Total Grant per Foreign Participant Grant Requested Total - Learning/Teaching/Training Activities PIC of Organisation Activity No. R Travel D NOTA BENE: AS DETAILED IN THE PROGRAMME GUIDE, THE GRANT SUPPORT FOR MULTIPLIER EVENTS WILL BE LIMITED TO A MAXIMUM AMOUNT OF 30.000 € PER PROJECT REGARDLESS OF ITS DURATION. Activity Type No. of Participants Distance Band T AF Total + - Subsistence Long-term Learning/Teaching/Training Activities PIC of Organisation Activity No. Duration (months) Activity Type Total + Country of Destination Total Travel Grant per Participant Grant Requested Total No. of Participants Grant per Participant/Month Grant Requested Total - Short-term Learning/Teaching/Training Activities Form hash code: Validate
- 16. Application Form Call: 2014 Erasmus+ PICof Organisation KA2 – Cooperation and Innovation for Good Practices Activity No. Activity Type Duration (days) No. of Participants Grant per Participant Total + Grant Requested Total - Linguistic Support - Special Needs + - Exceptional Costs PIC of Organisation + No. of Participants Activity Type Grant per Participant Total No. of Participants With Special Needs T AF PIC of Organisation Activity No. Grant Requested Total R + D PIC of Organisation Description of Cost Item Description Please list the activities to which this item refers to Grant Requested Total Please list the activities to which this item refers to Grant Requested Total - NOTA BENE: AS DETAILED IN THE PROGRAMME GUIDE, THE GRANT SUPPORT FOR EXCEPTIONAL COSTS WILL BE LIMITED TO A MAXIMUM AMOUNT OF 50.000 € PER PROJECT. Form hash code: Validate
- 17. Application Form Erasmus+ Call: 2014 KA2– Cooperation and Innovation for Good Practices Project summary Please provide a short summary of your project. Please recall that this section [or part of it] may be used by the European Commission, Executive Agency or National Agencies in their publications. It will also feed the Erasmus+ dissemination platform. Be concise and clear and mention at least the following elements: Context/background of project; objectives of your project; number and profile of participants; description of activities; methodology to be used in carrying out the project; a short description of the results and impact envisaged and finally the potential longer term benefits. In view of further publication on the Erasmus+ dissemination platform, please be also aware that a comprehensive public summary of project results will be requested at report stage(s). Final payment provisions in contract will be linked to the availability of such summary. T Form hash code: AF R D Please provide a translation in English. Validate
- 18. Application Form Erasmus+ Call: 2014 KA2– Cooperation and Innovation for Good Practices T AF R D Form hash code: Validate
- 19. Application Form Call: 2014 Erasmus+ KA2– Cooperation and Innovation for Good Practices Summary of participating organisations PIC of Organisation Name of the Organisation Country of the Organisation Total number of participating organisations T AF R D Form hash code: Validate
- 20. Application Form Call: 2014 Erasmus+ KA2– Cooperation and Innovation for Good Practices Budget Summary PIC of Organisation Project Management and Implementation Intellectual Outputs Learning/Teaching/Training Activities Multiplier Events Special Needs Travel Subsistence Exceptional Costs Total Linguistic Support Total Project Total Grant Grant Requested T AF R D Grant Calculated Form hash code: Validate
- 21. Application Form Erasmus+ Call: 2014 KA2– Cooperation and Innovation for Good Practices Checklist TBD T AF R D Form hash code: Validate
- 22. Application Form Erasmus+ Call: 2014 KA2– Cooperation and Innovation for Good Practices Data Protection Notice PROTECTION OF PERSONAL DATA The application form will be processed by computer. All personal data (such as names, addresses, CVs, etc.) will be processed in pursuant to Regulation (EC) No 45/2001 on the protection of individuals with regard to the processing of personal data by the Community institutions and bodies and on the free movement of such data. Any personal data requested will only be used for the intended purpose, i.e.: - In the case of grant application forms: the evaluation of your application in accordance with the specifications of the call for proposals, - In the case of application for accreditation forms: the evaluation of your application in accordance with the specifications of the call for proposals, - In the case of report forms: statistical and financial (if applicable) follow-up of the projects. For the exact description of the collected personal data, the purpose of the collection and the description of the processing, please refer to the Specific Privacy Statement accompanying this form. D You are entitled to obtain access to your personal data on request and to rectify any such data that is inaccurate or incomplete. If you have any queries concerning the processing of your personal data, you may address them to your National Agency. You have the right of recourse at any time to your national supervising body for data protection or the European Data Protection Supervisor for matters relating to the processing of your personal data. http://www.edps.europa.eu/ T AF R You are informed that for the purposes of safeguarding the financial interest of the Communities, your personal data may be transferred to internal audit services, to the European Court of Auditors, to the Financial Irregularities Panel and/or to the European Anti-Fraud Office (OLAF). Form hash code: Validate
- 23. Application Form Erasmus+ Call: 2014 KA2– Cooperation and Innovation for Good Practices Declaration of Honour To be signed by the person legally authorised to enter into legally binding commitments on behalf of the applicant organisation. I, the undersigned, certify that the information contained in this application form is correct to the best of my knowledge. I put forward a request of an Erasmus+ grant as set out in section BUDGET of this application form. Declare that: - All information contained in this application, is correct to the best of my knowledge. - In the case of projects in the field of youth, the participants involved in the activities fall in the age limits defined by the Programme. - The organisation I represent has the adequate legal capacity to participate in the call for proposals. EITHER The organisation I represent has financial and operational capacity to complete the proposed action or work programme OR The organisation I represent is considered to be a "public body" in the terms defined within the Call and can provide proof, if requested of this status, namely: D It provides learning opportunities and - Either (a) at least 50% of its annual revenues over the last two years have been received from public sources; - Or (b) it is controlled by public bodies or their representatives AF R I am authorised by my organisation to sign Community grant agreements on its behalf. Certify that (in case the grant requested exceeds 60.000€): The organisation I represent: - is not bankrupt, being wound up, or having its affairs administered by the courts, has not entered into an arrangement with creditors, has not suspended business activities, is not the subject of proceedings concerning those matters, nor is it in any analogous situation arising from a similar procedure provided for in national legislation or regulations; - has not been convicted of an offence concerning its professional conduct by a judgment which has the force of 'res judicata'; - has not been guilty of grave professional misconduct proven by any means which the National Agency can justify; T - has fulfilled its obligations relating to the payment of social security contributions or the payment of taxes in accordance with the legal provisions of the country in which it is established or those of the country where the grant agreement is to be performed; - has not been the subject of a judgment which has the force of 'res judicata' for fraud, corruption, involvement in a criminal organisation or any other illegal activity detrimental to the Communities' financial interests; - it is not currently subject to an administrative penalty referred to in Article 96(1) of the Financial Regulation (Council Regulation 1605/2002 of 25/06/02, as amended). Acknowledge that: The organisation I represent will not be awarded a grant if it finds itself, at the time of the grant award procedure, in contradiction with any of the statements certified above, or in the following situations: - subject to a conflict of interest (for family, personal or political reason or through national, economic or any other interest shared with an organisation or an individual directly or indirectly involved in the grant award procedure); - guilty of misrepresentation in supplying the information required by the National Agency as a condition of participation in the grant award procedure or has failed to supply this information. In the event of this application being approved, the National Agency has the right to publish the name and address of this organisation, the subject of the grant and the amount awarded and the rate of funding. Commit: Form hash code: Validate
- 24. Application Form Erasmus+ Call: 2014 KA2– Cooperation and Innovation for Good Practices - my organisation and the other partner organisations herein, to take part upon request in dissemination and exploitation activities conducted by National Agencies, the Executive Agency and/or the European Commission, where the participation of individual participants may also be required. I acknowledge that administrative and financial penalties may be imposed on the organisation I represent if it is guilty of misrepresentation or is found to have seriously failed to meet its contractual obligations under a previous contract or grant award procedure. Place: Date (dd-mm-yyyy): Name of the applicant organisation: Name of legal representative: Signature: National ID number of the signing person (if requested by the National Agency): Print Declaration of Honour T AF R D Stamp of the applicant organisation (if applicable): Form hash code: Validate
- 25. Application Form Erasmus+ Call: 2014 KA2– Cooperation and Innovation for Good Practices Annexes Please note that all documents mentioned in section "Checklist" need to be attached here before you submit your application online. File Name File Size (kB) Add Add Add Add Add Total Size T AF R D Form hash code: Validate
- 26. Application Form Erasmus+ Call: 2014 KA2– Cooperation and Innovation for Good Practices Submission Before submitting the form electronically, please validate it. Please note that only the final version of your form should be submitted electronically. Data Validation Validate Validation of compulsory fields and rules Standard Submission Procedure Submit Online Online submission (requires internet connection) Alternative Submission Procedure If you cannot submit your application online you can still do it by sending an email to your National Agency within the 2 hours following the official application deadline. The email must contain the complete electronic form and any file attachments you wish to send. You must also attach a snapshot of section "Submission Summary" indicating that this electronic form could not be submitted online. Your National Agency will analyse your situation and provide you with further instructions. Submission Summary Number D This table provides additional information (log) of all form submission attempts, particularly useful for the National Agencies in case of multiple form submissions. Time Event Form Hash Code Status Form Printing Print the entire form Print Form T AF R * means local PC time, which cannot be considered authoritative and cannot be used for claiming that the form has been submitted in time Form hash code: Validate