IMPACT7 2020 Application Form
Welcome to the IMPACT7 2020 application form! Below is the information we would like you to give us about your project/company/idea/innovation/solution*.

Applications close on 31 January 2020. Invitations to present at IMPACT7 2020 will be sent before mid-February 2020. Shortlisted applicants may be asked to provide further details about their project before this time.

This application form comprises the following short sections:
A. Your contact details
B. What is your project, what impact are you trying to have and what challenges are you trying to solve? (for more info on the 7 challenges visit:
C. Information about your presenter
D. Travel Grant
E. Referees
F. (optional) Links to further info.

Please note you cannot ‘save’ partially completed forms.

If you have any questions about the application process, please contact, Kate Lewis or call us on 03 9663 3093.

*Please note for the purpose of this form we will use the word "project" for your company/idea/innovation/solution.
Email address *
A) Your contact details:
Name: *
Your answer
Phone: *
Your answer
Your answer
In which state was your project born?
B) Tell us about your project:
1. What is the name of your project? *
Your answer
2. Describe your project (Please include what your project is, who is involved, and what is novel or unique about it.) 100 words max *
Your answer
3. Which challenge/s below does your project attempt to solve? (See more about challenges on the challenges page of the website). *
4. How does your solution/project/company attempt to address the challenge/s you indicated above? *
Your answer
5. What are you hoping to get out of participating at IMPACT7? *
Your answer
6. What is the biggest challenge you face in the next 12 months? *
Your answer
C) Tell us about your presenter:
7. Should your application be selected, who will represent your project at IMPACT7 on Tuesday 24 March 2020 in Melbourne? Please provide their name and contact details if different from above. *
Your answer
8. Please provide a short biography of your representative. Include professional biography, current role, and expertise. (100 words max) *
Your answer
9. Are you affiliated with a university, research institution or other organisation? If so, which one/s?
Your answer
D) Travel grant:
10. If you are selected to be part of IMPACT7 would you be interested in applying for a Travel Grant? (The Grant provides some assistance with your return travel from your Australian city to Melbourne on 24 March 2020)
E) Referees:
Who can verify the information you've provided here? Appropriate referees may include a mentor, collaborator, supporter or peer. Someone who can vouch for you is best!
Referee 1: Name, relationship to you and contact details
Your answer
Referee 2: Name, relationship to you and contact details
Your answer
F) Have more to tell us?
If you would like to point us to more information about your project (i.e. a website, journal publication, media coverage), please do so here.
Your answer
How did you hear about IMPACT7?
Your answer
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