Name *

City / Town of Residence *

Email Address *

Phone Number *

Are you available to attend the make-a-thon event on Saturday November 30th and Sunday December 1st? *

Are you available to attend the initial challenge presentation event at The University Of Sheffield on the evening of Friday Oct 25th or the afternoon of Saturday Oct 26th? *

Please tell us a bit about yourself, including any disabilities you experience *

Please describe a problem or difficulty you face that you would like to present as a challenge for the make-a-thon teams to design a solution for. This could be from any life activity, including pursuit of a hobby: *

Are there any solutions you have previously tried to address this challenge. In what ways were they unsatisfactory? *

Between the Challenge event and the make-a-thon, there will be five weeks (Oct 28th to Dec 1st) to work closely with your make-a-thon team. We will also be organising a series of interesting evening skill building workshops (2hrs each) at the University of Sheffield for you & your team to participate in. Please tell us about your availability during that time: *

How would you like us to contact you? *