INCLUSIVE INNOVATION AWARD APPLICATION FORM​

Personal Details
* - required to be filled

1. First Name *

2. Last Name *

3. Occupation *

4. Name of the organisation *

5. Type of organization - please select * —Please choose an option—StartupPublic SectorPrivate SectorUniversityNGOOther

6. Email *

7. Mobile No * (Acceptable format 10 digit no eg. 1122334455)

8. Country *

State *

City *

Innovation Details

9. What is the title of your innovation? *

10. Is your innovation - Please select * —Please choose an option—New to the worldNew to IndiaNew to a certain industry or area of operationsUnique in any other way

11. What problem does your innovation solve? *

12. How does your innovation solve this problem? Please explain in detail how your product, process or service works? *

13. Explain how your innovation benefits a large section of the population – especially disadvantaged or resource-poor people – and not just a few people. *

14. How is your innovation different from existing alternatives/solutions, if any? *

15. Explain how your innovation is of the highest quality, what technology it uses, etc.? *

16. What is (or will be) the final price of your innovation for the end-user or consumer (in Indian Rupees)? How does your innovation compare on affordability with existing alternatives/solutions? *

17. Which stage is your innovation currently in - Please select * —Please choose an option—CommercialisedReady for commercializationPrototype/Pilot/Demo/TrialsR&D/In preparation

18. What is your company’s business model and Go-to-Market Strategy? *

19. Please state the revenue generated (if any) by this innovation and the relevant time period.

20. Please mention names of investors and details of investments received, if any?

21. Have you filed for a patent? If yes, please share details.

22. Please specify previous awards, if any, won by the innovation?

23. Has the impact of your innovation been verified by an external agency or published? If yes, please provide a relevant reference (links or attachments).

24. Website Link

25. YouTube or Video Link

26. Please upload relevant and supporting documents (if any)For uploading more than 1 file, put the files in a folder, zip it and upload the zip folder.
Maximum upload size 2MB.