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Applicant Information
Applicant (Entrepreneur/Incubatee) Name
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Educational Qualifications
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Age
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Postal Address
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Telephone/Mobile
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Fax
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Email
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Website (if any)
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Current Professional /Employment status
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Company Information
Have you registered a company, give details
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Company Sector
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Name of applicant company/firm
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Location from which company is operating
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Relationship with the Business Incubator/ Host Institute
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Investment in plant and machinery (for manufacturingsector)/ Investment in equipment (for services sector)
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Company Type: Pl. refer to
http://www.dcmsme.gov.in/ssiindia/defination_msme.htm
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Project Information
Title of the technology/innovation
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Category of technology/ innovation (specify process/product/ new application / other)
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Specify the potential areas of application in industry/market
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If the idea involves use of existing intellectual property,give details of the owner of the same and arrangements of sourcing the innovation and terms of its commercialization
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Specify newness/ uniqueness of the innovation (betterperformance/ new features/ improvements)
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What is already available in market? What is the marketpotential? What value it would add in market
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Current Development Status of Innovation
What is the current development status of the innovation /product or service offerings? (Whether still an idea or ready to launch)
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Technology readiness level (Pl. refer tohttp://
en.wikipedia.org/wiki/Technology_Readiness_Level
)
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Specify the time period in months required for Innovationto be completely developed for field testing/ ready forintended end-user
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Financial Requirements
Do you have a business plan for taking innovation from labto market? (Details in Annexure I)
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What level of funding is required for making innovationmarket ready?(Details in annexure II)
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Please give activity wise break-up (Activities includedesign/prototype development/ lab/bench scaleproduction/professional services/hiring staff/ trials/testmarketing/miscellaneous)
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Other Related Information
Are there any team members/partner and mentors/guides inyour innovative project? If so give name and completecontact address with phone and e-mail)
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Information on Patents filed/granted (if any)
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Any awards or recognition related to the innovation
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Please include any further information that you wish to communicate to us to help us in judging your application
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