aanvraagsubsidie- g d m c（aanvraagsubsidie - g d m c）.docVIP

Application form National Roadmap for Large-Scale Research Facilities 2011 The completed application form with attachments should be sent electronically to NWO via Iris. Ensure that the form and attachments are saved in PDF format. Iris is accessible via the NWO website: www.nwo.nl/roadmap. If possible, please use the Verdana font, size 8.5, line spacing 13, when completing the form. Please read the brochure before completing this form. The closing date for the submission of applications is Wednesday 31 August 2011 at 23.59. The date on which you upload via Iris is the valid submission date. General information Kind of proposal (please choose only one type of proposal) New facility (not in NL Roadmap 2008) □ inclusion in the roadmap only (no request for funding) (type 1) X inclusion in the roadmap and request for funding (type 2) Facility from NL Roadmap 2008 □ progress report and request for funding (type 3) □ progress report only (no request for funding) (type 4) All the fields in this form must be filled in regardless of the type of proposal. Main applicant: 1. TUD Title(s) Prof. dr. ir. First name Peter Initials P.J.M. Surname van Oosterom male female Address for correspondence Technische Universiteit Delft, OTB Jaffalaan 9, 2628 BX Delft Telephone number 015 2786950 Fax 015 2784422 Email P.J.M.vanOosterom@tudelft.nl Website (optional) www.otb.tudelft.nl Co-applicants 2. Alterra Title(s) Dr. First name Jandirk Initials J.D. Surname Bulens male female Address for correspondence Alterra Droevendaalsesteeg 3, 6708 PB Wageningen Telephone number 0317 480700 Fax 0317 419000 Email Jandirk.Bulens@wur.nl Website (optional) http://www.alterra.wur.nl/ 3. DANS Title(s) Dr. First name René Initials R. Surname van Horik male female Address for correspondence Data Archiving and Networked Services (DANS) Anna van Saksenlaan 10, 2593 HT Den Haag Telephone number