STUDY INFORMATION
Project title:
Type of support requested (funding, Active pharmaceutical ingredient (API), services, drugs)
Aim (Primary and others)
Rationale (Scientific hypothesis)
Expected outcomes
Description of the method
Use of animals or human sample or their derivatives (brief description of the study)
Duration of the project
Type of API requested
Amount of API
Publication
References
Intellectual property (IP) background (describe the IP background, including IP rights owned by the proponent or others)
Note

Please note that this form must not contain personal data of the applicant or personal data of third parties.

Date: