CLUSTER CONNECT ECF Batch II Application form

Visitor Application Form

To consider your Visitor application, filling and submitting this form is mandatory. Deadline to submit your application: August 31, 2024. Filling all questions is mandatory
Please make sure to download and read the application form before submitting the full application

Contact Information

The information below should be completed by the designated focal person
Name*

First NameLast Name
Gender*
Position in the cluster*
Cluster Country *
Phone Number *
Email*
example@example.com
Nationality *
Age Range*

Cluster Information

Please fill below the required information of the cluster
Insert below the Cluster’s social media channels*
LinkedIn URL, Facebook URL, Twitter handle, Instagram handle
Cluster Name *
Insert the Cluster website link *
Cluster sector*
If you operate in a sector that is not listed in the dropdown, please specify the sector *
Cluster Country *
Cluster year of establishment (when did the cluster start its activities)*
Describe in a short paragraph the mission of the cluster*
Describe in a short paragraph the current services provided by the cluster*
Do you work on a:*

Local levelRegional levelGlobal level
Please list the countries that are addressed*
Total number of Cluster members*
Total number of active Cluster members*

Cluster Management
Do you have a well-defined management team?*

YesNo
Please check from the below occupied positions*

PresidentCEOCFOManagerSecretaryOther
Please provide the contact details ( Full Name, Email)*
How many Cluster managers are in the Cluster?*
How many staff are in the Cluster?*

Challenges and Outcomes

To become a Visitor, you should at least identify 3 challenges and define your desired outcomes/goals to be considered as a Visitor in the cluster connect missions
Challenge 1*
Challenge 2*
Challenge 3*
What are the desired outcomes/goals to be considered as a Visitor in the cluster connect missions? *

To be selected, Visitors are required to identify at least 2 potential Hosts that wish to implement the Cluster Connect mission with

It is advised that the Visitor contact the desired hosts prior to filling the application form
Host 1*
I have an established contact person at the designated Host 1*

YesNo
Established Contact person details*
Host 2*
I have an established contact person at the designated Host 2*

YesNo
Established Contact person details*
Host 3
I have an established contact person at the designated Host 3

YesNo
Established Contact person details
How did you hear about this call?*
Are you familiar with the process of applying to visas from your country of origin to the chosen host country?*

YesNo
Should be Empty:

Visitor Application Form