SC1: Health, demographic change and wellbeing – WP 2016-2017 CONSULTATION Part 1 – Information about suggested “topic” (This part contains information that could be communicated to the European Commission and the Programme Committee). 1.1. Area of interest Second area of interest (if needed) Please, select one Please, select one (Choose from the available list the one that better suits the proposed topic. If it could fit in two areas, please, indicate first the most adequate and then the second one. Full description of areas proposed in the following link) 1.2. Proposed Topic/area for WP 2016-2017 (and following) (Topics in Horizon 2020 – Societal Challenge 1: Health, demographic change and wellbeing are not too narrow; it should define a problem in a broad and not prescriptive way and open the floor for many projects, different approaches should be possible. No project descriptions are allowed here, only the problem/approach proposal) Title: Description (Be concise, only refer to the area of research/innovation proposed, max. 1000 characters): Expected Impact (Refer to the impact/s for the previously described area of research, max. 600 characters): Type of action: Please, select one (Choose from the proposed list) EC contribution: between and M€ (Indicate the proposed EC contribution per project) Key words (max. eight) Justification: (Why the topic should be included in the WP? What are the societal needs and/or strategic importance? Does it take into account current politically relevant international issues? What is the European added value? Will the topic fill strategically important research gaps at EU level? Does this topic support any EU policies beyond research? Can it be linked to any existing European research agenda or roadmap? What makes your topic outstanding compared to other funding activities in that field? max. 1000 characters) Instrucciones: Para enviar el formulario utilice el botón que encontrará en la parte superior derecha. En caso de que no fuera posible, envíelo como adjunto a belen.diaz@cdti.es SC1: Health, demographic change and wellbeing – WP 2016-2017 CONSULTATION Part 2 – Information about you/supporting entities (This part is for restricted use and the communication between you and the Spanish Delegation. Commission or the Programme Committee) Not to be communicated to the European 2.1 Contact Name of researcher/s (technical/scientific contact): Previous experience in EU projects (select from the provided list) Please, select one Institution: Website: Address: Email: Phone: Management office contact details (if needed): Name: Email: Phone: 2.2. Brief summary of the project to be summited to the proposed topic Description (Be concise, only key aspects of the research/innovation of the project, max. 1000 characters): 2.3. Topic supporting countries (Please indicate which countries are likely to support the suggested topic in the Programme Committee) Country Name & institution Support confirmed Please, select one Please, select one Please, select one Please, select one Please, select one Please, select one Please, select one Please, select one Please, select one Please, select one InstruFFLRQHV: Para enviar el formulario utilice el botón que encontrará en la parte superior derecha. En caso de que no fuera posible, envíelo como adjunto a belen.diaz@cdti.es