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1、二oo九年度國(guó)家技術(shù)發(fā)明獎(jiǎng)申請(qǐng)書application form for2009 state technological invention award【項(xiàng)目基本情況 general description of the project1. 項(xiàng)目名稱 project title2. 主要完成人 principal persons who complete the project(主要完成入的姓名應(yīng)按貢獻(xiàn)大小從左至右順序列出names of principal persons should be listed according to their contributions to the pro
2、ject)3. 項(xiàng)目名稱可否公布 can the projects title be disclosed 可 yes否 no保密期限 duration of confidentiality(年/year)4. 所屬或民經(jīng)濟(jì)行業(yè) the national economy industry sector that the project belongs to(請(qǐng)參照本申請(qǐng)書塡寫說(shuō)明的項(xiàng)目基本情況please see "general description of the project" of the notes on how to complete the applicati
3、on form for classification) a b c d e f g h i j k l m n o p q r s t5. 任務(wù)來(lái)源 source of task a.國(guó)家計(jì)劃 state plans (dai.國(guó)家科技攻關(guān)計(jì)劃 stated key technologies r&d programa2. 863 計(jì)劃 program ja3. 973 計(jì)劃 program jm.其他 others)n b.部委計(jì)劃 plans of ministries or commissions c.省、市、自治區(qū)計(jì)劃 plans of provinces, municipali
4、ties, or autonomous regions i d.基金資助 foundation (od1.國(guó)家自然科學(xué)基金 national natural science foundationd2.其他基金others) e.企業(yè) enterprises f.國(guó)際合作 international cooperationi_ g.非職務(wù) not within one's own job responsibilities h.自選 self-chosen i.其他 others6. 項(xiàng)目起止時(shí)間 project commencement and completion dates起始於 s
5、tarted from完成於 completed by(h/月/年 dd/mm/yy)(fi/月/年 dd/mm/yy)illi. 項(xiàng)目簡(jiǎn)介 brief introduction of the project項(xiàng)目所屬科學(xué)技術(shù)領(lǐng)域、主要技術(shù)內(nèi)容、授權(quán)專利情況、技術(shù)經(jīng)濟(jì)指標(biāo)及推廣應(yīng)用情況the scientific and technological area to which the project belongs to, major technological content, grant of patents and licensing condition, techno-economic
6、indicator, as well as promotion of application and effectivenessiil 主要技術(shù)發(fā)明點(diǎn) major technological inventionsiviv.項(xiàng)目詳細(xì)內(nèi)容 detailed information of the project1. 立項(xiàng)背景 background of setting up the project2. 科學(xué)技術(shù)內(nèi)容 scientific and technological content3. 與當(dāng)前國(guó)內(nèi)外同類技術(shù)主要參數(shù)、效益、市場(chǎng)競(jìng)爭(zhēng)力的比較;存在的問(wèn)題及經(jīng)採(cǎi)用的有效改 進(jìn)措施comparison
7、 with the major technological elements, efficiency and market competitiveness of similar technologies prevailing in the mainland and abroad; improvement made to existing problems after implementing the technology4. 知識(shí)產(chǎn)權(quán)授權(quán)情況 proof of intellectual property rights5. 應(yīng)用情況 application(不超過(guò) 15 頁(yè) not more t
8、han 15 pages )6. 經(jīng)濟(jì)效益(社會(huì)公益類、國(guó)家安全類項(xiàng)目可以不塡此欄)economic benefits (this part may not be required for public welfare and national security projects)單位:萬(wàn)元(港幣)unit: in ten thousand (hkd)回收期(年)yield (years)項(xiàng)目總投資額 total investment amount of the project年份year新增利潤(rùn)newly created profits新增稅收newly created tax創(chuàng)收外匯(港幣
9、)foreign exchangeearned (hkd)節(jié)支總額total expenses beingcut down累計(jì)total各欄目的計(jì)算依據(jù) the basis of calculation for each item(中文不超過(guò) 200 字;english not exceeding 100 words )7. 社會(huì)效益 social benefits本項(xiàng)目曾獲科技獎(jiǎng)勵(lì)情況information on science and technology awards given to this project獲獎(jiǎng)項(xiàng)目名稱name of awarded projects獲獎(jiǎng)時(shí)間dates
10、 ofaward prcscntation獎(jiǎng)項(xiàng)名稱name of awards獎(jiǎng)勵(lì)等級(jí)grades ofawards授獎(jiǎng)部門(單位)departments (units) whichconferred awardsvi. 主要證明目錄 list of major document proof1. 知識(shí)產(chǎn)權(quán)證明目錄 proof of intellectual property rights (ipr)授權(quán)項(xiàng)目名稱project title知識(shí)產(chǎn)權(quán)類別categories ofipr國(guó)別country申請(qǐng)?zhí)朼pplication no.授權(quán)號(hào)patent no.2. 應(yīng)用單位目錄 list of
11、organizations applying the project應(yīng)用單位應(yīng)用起始時(shí)間應(yīng)用單位使用本發(fā)明產(chǎn)生提交應(yīng)用organizations(年/月)聯(lián)絡(luò)人姓名及電話的經(jīng)濟(jì)效益(萬(wàn)港元)單位證明time of commencingname and phone no. ofeconomic benefitsproof of applyingapplication of thecontact person of theachieved by applyingorganizationprojectapplying organisationthe project()(mm/yy)(ten thou
12、sand hkd)3. 技術(shù)評(píng)價(jià)證明及國(guó)家法律法規(guī)要求行業(yè)審批文件目錄proof of technological assessment and approving documents on the industries required by the state's laws and regulations(中文不超過(guò) 800 字;english not exceeding 400 words)vii. 主要完成人情況*information on principal person who completes the project*姓名name性別m / fgender出生日期 d
13、ate of birth (mm/yy)出生地(省/市) place of birth (municipality/ province)民族e(cuò)thnicgroup身份證號(hào)碼id card no國(guó)籍nationality行政職務(wù) occupation工作單位unit in which principal person works完成單位unit in which the project completed通訊地址 correspondence address聯(lián)絡(luò)電話contact phone no.住宅電話phone no.(home)手提電話 mobile no.竜子信箱e-mailaddre
14、ss畢業(yè)學(xué)校school graduated畢業(yè)時(shí)間date of graduation文化程度education level技術(shù)職稱 technical title專業(yè)、專長(zhǎng) professional field or specially最高學(xué)位 academic degree曾獲科技獎(jiǎng)勵(lì)情 況technologyawards received參加本項(xiàng)目起止時(shí)間自from至tocommencement and completion date of project participation(mm/yy)對(duì)本項(xiàng)目技術(shù)創(chuàng)造性貢獻(xiàn) contributions to the major techno
15、logical content of the project(中文不超過(guò) 300 字;english not exceeding 150 words)日期date本人簽名signature of principalperson*據(jù)第一頁(yè)所塡寫的主要完成人'如超過(guò)一人完成項(xiàng)冃'所有完成人必須塡寫這份資料。如有需 要可影印此頁(yè)。referring to ”principal persons who complete the projectm on page 1, if more than one person complete the project, each of the pe
16、rsons involved has to fill in a form. this page can be photocopied if necessar y.viii. 附件目錄 table of contents of appendicesi 知識(shí)產(chǎn)權(quán)證明 proof of intellectual property rights2. 應(yīng)用證明 proof of applications3. 技術(shù)評(píng)價(jià)證明及國(guó)家法律法規(guī)要求行業(yè)審批文件proof of technological assessment and approving documents on the industries re
17、quired by the statens laws and regulations4. 其他證明 other proving documents5. 所有完成人的有效身份証明文件(如香港身份証、中國(guó)護(hù)照等)copy of the identity documents of all applicants (e.g. hong kong identity card, prc passport, etc.)註: 附件要求請(qǐng)參閱申請(qǐng)書塡寫說(shuō)明第viii部分,並提供目錄,順序排列及標(biāo)記note附件,以方便核對(duì)。for submission requirements on the appendices,
18、 please refer to part viii of the “notes on how to complete the application forrrt. the appendices should be labeled according to the order of the content page(2)所有提供的資料,將用作申請(qǐng)國(guó)家科學(xué)技術(shù)獎(jiǎng)。all information provided will be used for processing the entries.ixe 呈交申請(qǐng)書 submission of application申請(qǐng)書主件必須以中文及英文分別塡寫。請(qǐng)把已塡妥的申請(qǐng)書主件的軟複本(word format)連同一式四份的申請(qǐng)書主件及附件(活頁(yè)釘裝)親身或以專人派遞交回下列地址:the main application form should be completed in both chinese and english (in separate copy). please send one softcopy of the main application form (in word format) and four hardcopies of the main application form
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