STRATEGIC PLATFORMS PROGRAMME

EQUIPMENT-RELATED TRAVEL GRANT

APPLICATION FORM

1. APPLICANT

 If you have not registered your details on the NRF Online Submission System (https://nrfsubmission.nrf.ac.za),
kindly do so before submission to the institutional research office for validation.
 The Curriculum Vitae section forms an inherent part of the application and must be completed by all new
applicants and updated by all prior applicants.
 All sections of the Application Form must be completed in full.

Please provide additional details (copy and paste) if:

 A supervisor is applying on behalf of technician/student
 There are multiple applicants for the visit (adjust budget accordingly)

Where applicants fail to complete the NRF Online Registration and CV sections, the application will be deemed to
be incomplete and will not be considered for funding.

1.1. APPLICANT’S DETAILS (Principal Investigator, Student, Postdoc fellow)

Title Initials
First Name Surname
I.D. Number Gender/Sex M F
Citizenship Race B W
Department
Institution
Address

Postal Code E-mail

Telephone Fax
Nature of Full- Contract If contract appointment, specify duration after application
closing date
Appointment time Appointment

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1.2.Details of the Supervisor who is applying on behalf of a student OR Details of the Head of Department
who is applying on behalf of a technician
Title Initials
First Name Surname
I.D. Number Gender / Sex M F
Citizenship Race B W
Department
Institution
Address

Postal Code E-mail

Telephone Fax
Nature of Full- Contract If contract appointment, specify duration after application
closing date
Appointment time Appointment

2. SCHEDULING OF VISIT

 Give details of VISIT, not project, highlighting your research activities at the facility to be visited and the
envisaged outputs.
 Please note that a report on the visit / workshop must be submitted to the NRF within two (2) months of
completed visit to the facility.

Starting Date (dd/mm/yy) Completion Date (dd/mm/yy)

Duration

3. DETAILS OF VISIT

3.1. TYPE OF MOBILITY REQUESTED (indicate with X)

Local International
General Mobility Synchrotron
3.2. HOST INSTITUTION (motivate clearly the reason for selecting this particular facility for the
visit / workshop)

3.3. DETAILS OF HOST INSTITUTION

Contact Person
Department
Institution
Address

Postal Code Telephone

Fax No. E-mail

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4. DETAILS OF EQUIPMENT

4.1. NAME OF RESEARCH EQUIPMENT TO BE ACCESSED

4.2. DESCRIPTION OF RESEARCH EQUIPMENT (including specific features)

4.3. Please comment on the extent of your investigation to determine whether similar equipment
exists in your institution, region or elsewhere in South Africa and if available why these
cannot be used for your research. (Provide a letter of verification from such a facility).
DOES THE PROPOSED YES NO
EQUIPMENT EXIST IN OTHER
DEPARTMENTS AT YOUR
INSTITUTION?
(If YES, provide full details)
DOES THE PROPOSED YES NO
EQUIPMENT EXIST AT OTHER
INSTITUTIONS IN YOUR
REGION?
(If YES, provide full details)
DOES THE PROPOSED YES NO
EQUIPMENT EXIST
ELSEWHERE IN SOUTH
AFRICA? (If YES, for state-of-
the-art equipment, provide a
detailed description of the
equipment, its location and
ownership. Indicate whether
the equipment is available
from a science council
and/or commercial company
e.g. SASOL or ESKOM)

4.4. PURPOSE OF THE VISIT AND DETAILS ON THE SCIENTIFIC IMPACT OF THE PROJECT
Provide details on how the current or envisaged future research project will be impacted using
this particular piece of equipment

4.5. RATIONALE & MOTIVATION

Provide details of the suitability of technique, objectives of using the particular instrument,
choice of specific instrument, host, institution, training organization (Provide a letter of
invitation from the host to substantiate the invitation).

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4.6. ENVISAGED RESEARCH OUTPUTS AS A RESULT OF THE VISIT (publications etc.)

4.7. ENVISAGED TRAINING AND OUTREACH INTERVENTIONS

Specifically indicate the mentoring plan for young researchers from HDIs, local
seminars/training workshops etc.

4.8. POTENTIAL IMPACT ON HR DEVELOPMENT (students, other technical staff)

How will the training obtained at the proposed facility impact on HRD?

4.9. POTENTIAL IMPACT ON EQUITY AND REDRESS

How will the training obtained at the proposed facility be implemented at your own
organisation to address the equity and redress requirements

5. BUDGET
PROPOSED EQUIPMENT-RELATED TRAVEL BUDGET
ITEM Description Cost
Air Ticket (copy of quotation
/proof of return flight cost must    
be provided)
Travel Expenses
Transport at Destination (car
   
rental, bus, train)
SUB-TOTAL    
 
Subsistence
Expenses (the
Accommodation    
NRF is guided by
the tariffs as
prescribed in the
Government
Gazette and
applicants are Daily Allowance    
advised to consult
it)

  SUB-TOTAL  
 
  OWNER OF EQUIPMENT

Running Hourly rate No of

     
Expenses (operator) hours
Service Fees Hourly rate No of
     
charged Equipment use hours
 
  SUB-TOTAL

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 TOTAL VISIT
Add the subtotals for Travel + Subsistence + Running Expenses
COSTS
Supplier / Manufacturer Co-Investment  
LESS Host Institution Co-Investment  
SUPPLEMENTARY
FUNDING HEI Contribution  
Other  
  SUB-TOTAL  

TOTAL REQUESTED FROM THE NRF (Total visit costs less contributions to be derived
 
from other sources)

# ALL COSTS MUST BE QUOTED IN RANDS

6. DECLARATION BY APPLICANT

DECLARATION BY APPLICANT

I, …………………………………………………… representing …………………………………….

who intends using the equipment needed for this project, hereby declare that I have consulted with the
owner/host institution of the equipment and that I am satisfied that the equipment has adequate specifications
(e.g. resolution, sensitivity, energy, physical dimensions, sample size, etc.) to address the research project under
investigation. I also declare that no funding has been received or awarded from other sources for the purpose of
this application, except for those indicted under SUPPLEMENTARY FUNDING.

I confirm that I have arranged with my own relevant Institutional authorities to provide any shortfall in funding.

Signature: ……………………………………….. Date: …………………………………………

7. APPROVAL BY DESIGNATED AUTHORITIES AT YOUR RESEARCH INSTITUTION

(Research Administration or Equivalent Executive)

Designated Authority OR Equivalent Executive of APPLICANT

Name Capacity Signature

Telephone Fax No:

e-mail Date

8. APPROVAL AND DECLARATION OF HOST / TRAINING INSTITUTION (Kindly append the

formal letter of invitation from the research facility director, at which the equipment you need to access is
housed; or confirmation of acceptance to the training course/workshop.)

I, …………………………………………………… representing …………………………………….

who intends hosting / training the following person(s)………………………………………………………………………., hereby

declare that I have discussed and consulted with the above-mentioned person(s) the suitability of the equipment
/training outcomes with respect to the research project they are undertaking / envisage to undertake.

Signature: ……………………………………….. Date: …………………………………………

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