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Application Form - Sankalp Southeast Asia Awards 2017
Thank you for your interest in the Sankalp Southast Asia Awards 2017.

The Top 6 finalists will have the exclusive opportunity to pitch to leading investors at the Sankalp Southeast Asia Summit during September 19-20 in Jakarta, along with expert advice from mentors.

Before starting your application, please read the Criteria and Benefits http://www.sankalpforum.com/summit/3rd-sankalp-southeast-asia-summit-2017/. (We need a specific Link here)

On behalf of the Sankalp Forum team, we wish you luck!

Last Date for Submission: July 15, 2017

Eligibility

As an applicant/nominee to the recognition, your business must be:

1. Structured as “For Profit” Businesses, registered in Cambodia, Indonesia, Malaysia, Philippines, Singapore, Thailand and Vietnam.

2. In operation for a minimum of 6 months to a maximum of 5 years

3. Revenue of < USD 1.5 mn and/or <100 employees

With an operational focus in any one of the sectors:

a. Agriculture, Food and Rural Businesses
b. Education and Skill Development
c. Health, Water and Sanitation
d. Renewable and Clean Energy
e. Technology for Development
f. Urban Development and Affordable Housing
g. Waste Management
Instructions for Participation

Please carefully read the following instructions before starting the application.

1. Partial application CANNOT be saved to be completed at a later time. We advise drafting your answers in a separate word document (always a best practice in case you lose the online form) and fill out the application at one go.
2. Respond to all of the questions relevant to your business to the best of your ability, concisely, in accordance with the word limit, and use United States Dollars (USD) for monetary values.
3. To submit your application, click “Next” at the bottom of this page, fill in all applicable questions, and click “Submit” at the end of the application. Only applications submitted on this site (NOT in print) by July 15th, 2017 will be accepted.

Email: sankalpforum@intellecap.com
Website: http://www.sankalpforum.com/#

Terms and Conditions

1.The Sankalp South East Asia Awards organizing committee does not take any responsibility for disputes related to awards given to entrepreneurs.
2.The decision will be made at the sole discretion of an independent jury and will be final and binding.
Sankalp South East Asia Awards winners are not guaranteed enterprise investment. All structured investment instruments awarded, including debt and equity, will undergo the standard due diligence process, as mandated by the financing body.
3.Intellecap will keep all intellectual property disclosed in the nomination form strictly confidential. No enterprise or personal information will be given to third parties without prior consent.
4.It is the sole responsibility of enterprise representatives to utilize awards process benefits (e.g. workshops, mentoring, etc.) offered by the Sankalp Forum.
5.Winners will be requested to actively promote their awards and share information about the Sankalp Forum, as an ambassador of the initiative.

I hereby certify that all submitted information is true to the best of my knowledge and that misrepresentation of any kind will be sufficient grounds for disqualification. I also consent to all Terms and Conditions of the Sankalp Southeast Asia Awards 2017. If you agree to the statement above, please select agree, below. Only applicants that agree to the Terms and Conditions will be considered.
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Last Name
Email Address
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Mobile Number (Country code/ Mobile number)
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