Name of the Proposer *

Institution (name, address) *

Email of the point of contact *

Title of the Proposal *

Short summary *

Level of Funding requested *

Did the project previously apply for Europlanet funding?* if yes, please specify

Will the project receive funding or support from other sources (e.g. EU projects, research councils, space agencies)?* if yes, please specify

Short Description of the Project (200 words max.) *

Relevance to the Europlanet Society objectives (100 words max.) *
Explain how this proposal supports the aims of the Europlanet Association.

What is the proposed timeline for the project to take place?*

Where will the project take place / which areas will it reach? *

Estimated number of people reached by project *

Audiences reached *
Who are the main audiences targeted by the proposal? (Check as many boxes as are relevant)

Early CareerIndustryPlanetary Science CommunityOther Research CommunitiesAmateur CommunitySchools and Public

Support required from Committees and Working Groups *
Will this proposal need to call on additional support from any of the following Europlanet Society Committees or Working Groups?

Benelux HubCentral Europe HubFrance HubGermany HubItaly HubIreland & UK HubNorthern Europe HubSoutheast Europe HubSpain & Portugal HubSwitzerland HubEarly Career (EPEC)DiversityIndustry Working GroupOutreach Working Group

Do you intend to organize this project with other regional (s) hub(s)? *

Budget breakdown *
Provide a summary of how the funding will be used (600 words max)

Relevant link(s) for further information