IdeaLab Program Batch 5- Application Form

IdeaLab Program - Application Form

We invite you to fill out this application form to provide additional information about your startup. Please note that this application will take about 10-15 minutes to complete. All information you provide will be kept confidential and only used for evaluating your application. Apply before the 3rd of August.
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Startup Name*

Brief About the startup
Full Name of the startup’s representative *

First NameLast Name
Select the most convenient region to attend Idea Lab*

North Lebanon - INJAZ LebanonBekaa - Michel Daher Social FoundationMount Lebanon (Jbeil-Keserwen-Matn) - USEK Asher Center for Innovation and EntrepreneurshipBeirut - Farah Social FoundationMount Lebanon (Baabda-Shouf-Aley) - Park Innovation
Is there a second location that is convenient for you to attend the idea lab?

YesNo
Select which region*

Beirut - Farah Social FoundationNorth Mount Lebanon - Asher Center for Innovation and EntrepreneurshipSouth Mount Lebanon - Park InnovationNorth Lebanon - INJAZ LebanonBekaa - Michel Daher Social Foundation
Short description about your startup/Idea*

Up to 100 words summarizing what you are working on0/100
Sector*
If other, please specify:*
Startup's Governorate*
District*
District*
District*
District*
District*
District*
District*
District*
The year your startup/idea was created *

Business Model
Problem/Solution Fit: What is the main problem you are trying to solve? How does your solution solve this problem? *
Innovation/Impact: Why is your idea innovative? How is it impactful (environmental, social, economic ...)? *
Revenue: Who are your target customers? How are you planning to generate revenue? *
Competitive Advantage: What makes your solution unique? How is your solution different from your competitors? (mention your competitors)  *

Founders' Details
Number of founders*
Founder #1 (Startup's Representative) *

First NameFather's NameLast Name
Founder 1 Email Address*
example@example.com
Founder 1 Phone Number*
Please enter a valid phone number.
Educational Background*
Gender*
Age Range*
Age Category

YouthAdult
Nationality*
Living with disability:*

YesNo
Founder #2*

First NameFather's NameLast Name
Founder 2 Email Address*
example@example.com
Founder 2 Phone Number*
Please enter a valid phone number.
Educational Background*
Gender*
Age Range*
Age Category

YouthAdult
Nationality*
Living with disability:*

YesNo
Founder #3*

First NameFather's NameLast Name
Founder 3 Email Address*
example@example.com
Founder 3 Phone Number*
Please enter a valid phone number.
Educational Background*
Gender*
Age Range*
Age Category

YouthAdult
Nationality*
Living with disability:*

YesNo
Founder #4*

First NameFather's NameLast Name
Founder 4 Email Address*
example@example.com
Founder 4 Phone Number*
Please enter a valid phone number.
Educational Background*
Gender*
Age Range*
Age Category

YouthAdult
Nationality*
Living with disability:*

YesNo
Founder #5*

First NameFather's NameLast Name
Founder 5 Email Address*
example@example.com
Founder 5 Phone Number*
Please enter a valid phone number.
Educational Background*
Gender*
Age Range*
Age Category

YouthAdult
Nationality*
Living with disability:*

YesNo

About your solution
At what stage is your idea?*

Still an ideaI have validated my ideaI have been working on a prototypeI have a minimum viable productI am currently in the marketOther
Is your solution:*

HardwareSoftwareIOT (Hardware and Software)ScienceServiceOther
Have you previously joined an accelerator or received a grant?*

Yes, for the same startup I am applying toYes, for another product/service that my startup providesYes, for another startupNo
Please provide additional information (name of the program, type of support received, grants received, ...) *

Benefits of joining the IdeaLab
How can you benefit from the IdeaLab? Why should you be selected? *
If accepted into the program, are the co-founders committed to attend the IdeaLab full-time ? (i.e. 5 in person training session, weekly online clinics, in person demo day for a period of 3 months)*

YesNo
Where did you hear about Idea Lab Program?*

BerytechFarah Social FoundationUSEK Asher Center for Innovation and EntrepreneurshipPark InnovationINJAZ LebanonMichel Daher Social FoundationOther
How did you hear about the Idea Lab Program?*

NewsletterFacebookInstagramThreadsLinkedInTwitterDirect contact with the organization teamOnline ResearchRead in the newsInfo sessionsReferralOther
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