Application form
In the framework of Startup10 program, which aims to promote food security and youth employment in ten (10) Italian cooperation partner countries (Albania, Algeria, Bosnia-Herzegovina, Egypt, Ethiopia, Jordan, Kenya, Lebanon, Tunisia and Uganda), seven (7) startup companies candidates will be recruited by Technology Transfer Office (TTO), “Ismail Qemali” of Vlore to participate to the program of development of local startup companies operating in the green and blue economy sectors, with a focus on digitization processes.
The successful candidates will benefit from a support course in the form of coaching, at the end of which they will have the opportunity to present a pitch of their projects to a jury composed of national and international experts who will choose 1 winner. The award for the winner consists in a prize of € 5.000,00 to be used in the form of support tools, training, coaching, services and equipment according to the choice of the winners, together with an Open Innovation program with an Italian company.
The Rules of the Call for Application, published on the website of STARTUP10 program (https://www.startup10medafrica.com/call-for-startups/) and on the website of the University Technology Transfer Office (TTO), “Ismail Qemali” of Vlore, contains all information on the conditions of participation, registration, selection criteria and the conduct of the STARTUP10 Call for Applications.
Participation in the call for applications implies the unconditional acceptance by the candidates of the said Regulation in its entirety, the rules of ethics in force on the Internet, as well as laws, regulations and other texts applicable in the countries concerned by the STARTUP10 program.
This registration must be received at Technology Transfer Office (TTO), “Ismail Qemali” of Vlore in the manner indicated at Lgj. Pavarsia, no later than May 11, 2024 (23:59 CET time).
1. GENERAL INFORMATION OF THE APPLICANT/LEADER OF THE COMPANY
1.1. Photo (optional):
1.2. Name and Surname of the project leader:
1.3. Date of birth:
1.4. Sex: F ☐ M ☐ Prefer not to say ☐
1.5. Personal Address:
1.6. City of residence:
1.7. References of a valid identity document:
1.8. Adress mail:
1.9. Telephone mobile:
1.10. Level of education:
2. GENERAL INFORMATION OF THE COMPANY
2.1. Name of the organisation:
2.2. Year of establishment:
2.3. Address:
2.4. Postal code:
2.5. Headquarters city:
2.6. Web site:
2.7. Please provide a working social media URL of your STARTUP (if available)
2.8. Number of founders: _________
3. DESCRIPTION OF THE COMPANY:
3.1. Your company in a tweet – summary (non-confidential – 280 characters – take care of writing, content can be used for communication purposes):
3.2. History of the company (describe the story behind the company, from idea to current state – 300 words max)
3.3. Issues the company seeks to address (150 words max):
3.4. Product/Service description (500 words max, it is also possible to attach illustrations, photos or diagrams clear printed in high definition and colour)
3.5. Focus of the company: (for details refer to Rules of the Call for Application at Art.4.2)
3.5.1. ☐SUSTAINABLE MANAGEMENT OF NATURAL RESOURCES
3.5.2. ☐SMART FARMING
3.5.3. ☐CROP PROTECTION & FERTILIZERS
3.5.4. ☐BIOTECH
3.5.5. ☐LIVESTOCK & POULTRY
3.5.6. ☐FARMING & ROBOTICS
3.5.7. ☐INNOVATIVE FOOD PRODUCTS
3.5.8. ☐VALORIZATION OF NEGLETED AND UNDERUTILIZED CROPS (NUS)
3.5.9. ☐NOVEL FARMING SYSTEMS
3.5.10. ☐POST HARVEST
3.5.11. ☐FARM TO CONSUMER
3.5.12. ☐RECYCLING AND WASTE MANAGEMENT
3.5.13. ☐IRRIGATION & WATER MANAGEMENT
3.5.14. ☐SUSTAINABLE FISHERIES
3.5.15. ☐AQUACULTURE
3.5.16. ☐SUSTAINABLE TOURISM
3.5.17. ☐RENEWABLE ENERGY, ENERGY EFFICIENCY
3.5.18. ☐SUSTAINABLE TRANSPORT
3.5.19. ☐SUSTAINABLE BUILDING
3.5.20. ☐SUSTAINABLE DIET EDUCATION
3.5.21. ☐ICT
3.5.22. ☐OTHER (Specify)
3.6. Stage of development of the product/service
3.6.1. Product/Service fully developed Yes ☐ No ☐ in process ☐
3.6.2. Market validation attained Yes ☐ No ☐ in process ☐
3.6.3. Sales record to date Yes ☐ No ☐
3.6.4. International sales to date Yes ☐ No ☐
3.7. Target market (100 words max):
3.8. Growth strategy: (200 words max):
3.9. Details of the innovative aspects and/or degree of technology implemented (150 words max):
3.10. Positive impact on the environment and response to the Sustainable Development Goals (100 words max):
3.11. Number of team members ____
3.12. Composition of team members (describe your team and why it is the best team in the world in 250 words)
4. EXPECTATIONS
4.1. What is the main reason for submitting this application? (max 150 words)
4.2. What are you expecting to get from the participation to the Startup10 project? (max 150 words)
Optional: you can add any file you deem useful for the constitution of your folder. Please ensure that the file submitted per applicant is unique by linking all other documents.
5. DECLARATION
I declare that I have read and accept the rules of the contest published on the website of STARTUP10 program which gathers all the information on the conditions of participation, the registration, selection criteria and conduct of the STARTUP10 program Call for Applications.
Place: Date:
Signature
STARTUP10 – Application form_UNIVLORA-1