Zika Hack-a-thon Application
EVENT DATE: April 2-3, 2016

An urgent call to develop innovations that address the spread of the Zika virus and other vector-borne diseases

Attention designers, engineers, clinicians and all innovators! We need your knowledge and expertise for a 48-hour hack-a-thon to create new product concepts, design novel personal protective equipment and develop new methods for local vector control that will help bend the curve of the Zika epidemic and similar outbreaks.

DEADLINE: Wednesday, March 23, 2016

Visit the event website here: www.mghcgh.org/camtech/zika-hack-a-thon

About You
Name *
Your answer
Email Address *
Your answer
Phone Number *
Your answer
Gender *
Institution *
The entity (company/university/makerspace) you are currently affiliated with. Please enter N/A if this does not apply to you.
Your answer
Where do you currently live or work? [City, State]
Your answer
Where do you currently live or work? [Country]
Your answer
If you are traveling from outside the Boston area, do you have funding to support your travel?
*Please note that at this time, we are not able to provide travel support for hack-a-thon participants.*
Are you a student? *
Background *
Choose the one that describes your background the best. If you are a student, choose your field of study.
Have you participated in a medical technology hack-a-thon before? *
If yes, was it organized by CAMTech or Hacking Medicine?
What are your primary goals for the hack-a-thon? *
You can choose more than one.
Required
About Hacking
Attending the hack-a-thon from 9am on Saturday, April 2, until 7pm on Sunday, April 3, is essential. Will you be able to attend both days? *
If you answered "no" for the above question, please explain. *
In case you answered yes, please enter N/A.
Your answer
What strengths will you bring to your team while putting a hack together? 600 characters or less. *
Your answer
Describe a zika-related healthcare problem that you would like to solve. 600 characters or less. *
Focus on articulating the problem statement. Who is affected by it? How severe is the problem? Why are current solutions inadequate? Be succinct.
Your answer
Is there anything else you'd like to share? Optional, 400 characters or less.
Feel free to use this section to talk about anything else that will help others seek you out as a valued teammate.
Your answer
About the event
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