1. Personal Information (Where correspondence should be sent)
Home Office
Title
Applicants Name
Street Address
(Addtional line)
Post Code
Phone
eMail
Academic Institution/Department
Select one:
Publication Research Dissertation research Conference Visiting Professor Other
2. Title of Project
3. Description of Proposal
(May attached additional files below if necessary - MAXIMUM 2 pages) (Please include information on the relevant of the project within its field and vis à vis the goals of this Program as well as its expected outreach)
4. Project's itemized budget:
5. Breakdown of the above budget showing matching funds:
a) Funds provided by the applicant's institution and/or financial assistance from other sources. Include person contributions.
b) Funds requested from the Program for Cultural Cooperation. (This total may not exceed the amount shown in 5a and may not be more than 50% of the amount shown in #4):
6. If proposal is funded, cheque should be made payable to:
7. Any additional files
