Form

Apply EPIC Futures NI Phase 2 Commissioning Call

Lead Applicant Details

Full Name *

Email Address *

Gender *

• Woman
• Man
• Non-binary
• Prefer not to say

Registered Name of the Lead Organisation *

Registered Company/ Charity Number of the Lead Organisation

Registered Address of the Lead Organisation *

Organisation type of lead applicant *

• Research Institute
• University
• Community Interest Company (CIC)
• College
• Social Enterprise
• 'Not for Profit' Community and Voluntary Organisation
• Registered Charities or Charitable Incorporated Organisations
• Sole Trader (VAT Registered)
• Small and Medium Enterprise (SME) (VAT Registered)
• Large Enterprise (250 + staff) (VAT Registered)
• Other

If Other, please specify

Is the lead organisation/ applicant working in partnership with other researchers/ organisations as part of this proposal? *

• Yes
• No

If Yes, Please list the partner organisations for the proposal with full names of co-investigators. * If No, please enter "Not Applicable".

Theme(s) of Research *

Title of Research *

Type of Research Study *

Summary of Research (300 words maximum) *