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ANNEX 2

APPLICATION FORM(English version)

Innovation Awards for Franco-Chinese Teams 2016 Edition

Summary of items to be submitted (please tick the box to confirm that you have submitted the items):

A. Executive Summary and description of the Project and its characteristics B. Detailed description of the Project C. Economic Viability of the Project D. Usefulness of the project in social, economic, industrial and environmental terms E. Commitment form for Teams and Team members F. Authorization form for the communication and publication of information G. Team overview and structure, highlighting the team's Franco-Chinese bi-cultural aspect Annex: Detailed CV of Team members (optional)

For Jury use only

File No.: Received

Award being competed for: R&D Award Innovative Product Award Innovative Initiative Award

Name of the group of natural persons and/or legal person:

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A. Executive Summary and description of the project(1/2 page of A4 in Word format, Arial 1)

NON-CONFIDENTIAL DESCRIPTION OF THE INNOVATION (RESEARCH PROJECT, PRODUCT, SERVICE, PROCESS, IDEA, SOFTWARE, BUSINESS MODEL, ORGANIZATIONAL METHOD…)

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PROJECT TITLE:..............................................................................................................................................................................................................................................................................FOR R&D AWARD APPLICANT, the date of submission to a notary or public office to mark the priority (pursuant to Article 3.9.2)..............................................................................................................................................................................................................................................................................FOR INNOVATIVE PRODUCTS AWARD APPLICANT, the date that the patent was filed (pursuant to Article 3.9.3)..............................................................................................................................................................................................................................................................................FOR INNOVATIVE INITIATIVE AWARD APPLICANT, the date that communication of the initiative was made on any public medium in France or China (pursuant to Article 3.9.4).................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................

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B. Detailed description of the project (Innovative aspects)

(maximum of 2 pages of A4 in Word format, Arial 11)You may also describe your Project in a one-minute video (Smartphone quality)

Detailed description (maximum of 1 page of A4 in Word format, Arial 11)............................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................

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INNOVATIVE ASPECTS OF THE INNOVATION YOU HAVE IMPLEMENTED (TECHNICAL FEASIBILITY) (maximum of 1/2 page of A4 in Word format, Arial 11)

Technological innovation: Non-technological innovation:

Comments, if any:................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................

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INDUSTRIAL PROPERTY MANAGEMENT (title, geographical scope, technological monitoring, value such as licenses, etc), if applicable (1/2 page of A4 in Word format, Arial 11).

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BENCHMARKING WITH COMPETITIVE EXISTING INNOVATION(maximum of 1/2 page of A4 in Word format, Arial 11)

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PREVIOUS AWARDS AND DISTINCTIONS GRANTED FOR THE PROJECT PRESENTED FOR THE INNOVATION AWARDS FOR FRANCO-CHINESE TEAMS (maximum of 1/2 page of A4 in Word format, Arial 11)

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C. Economic viability of the Project (maximum of 2 pages of A4 in Word format, Arial 11)

COMPETITIVE ADVANTAGES (1/2 page of A4 in Word format, Arial 11)

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COMPETITIVE INFORMATION (BENCHMARK) (1/2 page of A4 in Word format, Arial 11)

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TARGETED APPLICATIONS (1/2 page of A4 in Word format, Arial 11)

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EXISTING OR FUTURE PARTNERSHIPS TO DEVELOP THE PROJECT (PUBLIC LABORATORIES, TECHNICAL CENTERS, COMPANIES, ETC.) – (maximum of 1/2 page of A4 in Word format, Arial 11)

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FOR R&D AWARD PLANNED EXPENDITURE ESTIMATES UNTIL THE INNOVATION'S MARKETING

STAGE – (maximum of 1 page of A4 in Word format, Arial 11).....................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................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FOR R&D AWARDS STUDIES TO BE CARRIED OUT (TECHNOLOGICAL, MARKETING, FINANCIAL,

LEGAL, ETC.) (1/2 page of A4 in Word format, Arial 11)............................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................

FOR INNOVATIVE PRODUCT AWARD ADDITIONAL TRAINING TO BE PROVIDED TO TEAM MEMBERS (IF

APPLICABLE) (1/2 page of A4 in Word format, Arial 11)............................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................

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FOR INNOVATIVE PRODUCT AWARD R&D EXPENSES

R&D BUDGET AS A PERCENTAGE OF TURNOVER (WORLDWIDE AND CHINA)(1/2 page of A4 in Word format, Arial 11)

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FOR INNOVATIVE PRODUCTS AWARD PROPORTION OF TURNOVER GENERATED BY THE NEW PRODUCT SINCE

BEING MARKETED (1/2 page of A4 in Word format, Arial 11)..........................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................

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D. Usefulness of the project(in social, economic, industrial and environmental terms)

(maximum of 2 pages of A4 in Word format, Arial 11)

USEFULNESS OF THE PROJECT IN SOCIAL TERMS (1/2 page of A4 in Word format, Arial 11)

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USEFULNESS OF THE PROJECT IN ECONOMIC TERMS (1/2 page of A4 in Word format, Arial 11)

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USEFULNESS OF THE PROJECT IN ENVIRONMENTIAL TERMS (1/2 page of A4 in Word format, Arial 11). Taking into account the entire life cycle, consumption and emissions, strengths and weaknesses, give elements with precise figures.

Please answer the following questions if applicable:

1. Calculation of economic profit in terms of reducing greenhouse gas emissions or reduction of energy consumption

2. Absence of impact of the innovation (in technological or non-technological terms) o the targeted environmental benefit – give elements to argue the answer.

3. Evidence with precise figures, illustrating the stakes in the fight against climate change corresponding to the diffusion of innovation

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USEFULNESS OF THE PROJECT IN INDUSTRIAL TERMS (1/2 page of A4 in Word format, Arial 11)

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E. Commitment form for Teams and Team membersI, the undersigned ....................................................................................................................(Surname and forenames,...............................................................................................................Date and place of birth) ..................................................................................................................

Residing at ...............................................................................................................................(Full mailing address)....................................................................................................................................................................................................................................................................................................

Representing the Team [Name of Team]

am a candidate for the

R&D Award Innovative Product Award Innovative Initiative Award

of Franco-Chinese Teams

and agree to abide by all clauses in the Terms and Conditions of the Innovation Awards for Franco-Chinese Teams.

Done in ........................ on .................2017

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F. Authorization form for the communication and publication of information

One form for each Team member must be completed, signed and returned with the application form

I, the undersigned ....................................................................................................................(Surname and forenames,...............................................................................................................Date and place of birth) ..................................................................................................................

Residing at ...............................................................................................................................(Full mailing address)....................................................................................................................................................................................................................................................................................................

Member of Team [Name of Team]

am a candidate for the

R&D Award Innovative Product Award Innovative Initiative Award

of Franco-Chinese Teams

and authorize the Organizing Institution to publish all contacts, information and a non-confidential Project description, as indicated on my Team's application form, in any advertising media as part of the Innovation Awards for Franco-Chinese Teams.

Done in ........................ on .................2017

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G. Team overview and structureHighlighting the team's Franco-Chinese bi-cultural aspect

Name of the Team:.............................................................................................................

Structure that the Team is part of

Type of structure......................................................................................................................................................

Size of structure......................................................................................................................................................

Number of employees/researchers/studentsWorldwide ....................................................................................................................................China.............................................................................................................................................

TurnoverWorldwide.....................................................................................................................................China.............................................................................................................................................

Motivations and personal commitments of the Team and Team members

(Signature required)

Annex: detailed CVs of Team members (optional) (maximum of 1 page per CV)

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Names and identities of team members as well as professional experience and skills that the Team and Team members possess

You are:

1. The Team's French representative

Surname: ............................................................. Forename(s)…........................................... Date and place of birth: ................................................................... Sex: F _ M _Nationality: ...............................................................................................................................

Home address:.........................................................................................................................Telephone No.: ......................................... Mobile No.: ...........................................................Email: .......................................................................................................................................

Or,

2. The Team's Chinese representative

Surname: ............................................................. Forename(s)…........................................... Date and place of birth: ................................................................... Sex: F _ M _Nationality: ...............................................................................................................................

Home address:.........................................................................................................................Telephone No.: ......................................... Mobile No.: ...........................................................Email: .......................................................................................................................................

You are: A student Employed

If you are employed, please specify:Your current company: ............................................................................................................Your position within the company:...........................................................................................

Education level:_ BAC _ BTS/DUT_ Licence 1 _ Licence 2 _ Licence 3_ Masters 1 _ Masters 2 _ Doctorate_ Engineer _ Other (specify):………….......

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3. Composition of the Team

Please indicate for each member of the Team:

French members:Surname: Forename(s): Age: Sex: F_

M_ Education:

(Reproduce the table as many times as there are French team members)

Chinese members:Surname: Forename(s): Age: Sex: F_

M_ Education:

(Reproduce the table as many times as there are Chinese team members)

Members of another nationality (if applicable)Surname: Forename(s): Age: Sex: F_ M_

Education:

(Reproduce the table as many times as there are team members of another nationality)

Institution Year Course taken Degree obtained (specify the grade)

Skills/knowledge acquired

Institution Year Course taken Degree obtained (specify the grade)

Skills/knowledge acquired

Institution Year Course taken Degree obtained (specify the grade)

Skills/knowledge acquired

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