Submit Your Startup
Application Form
If ​You are a startup you​ must ​be a part of YI INNOVEX @ MIO.
1. All fields with a * are mandatory.
2. Challenge is open to all Indian Institutions, organizations, and individuals in India. Any Indian applicant based outside of India is eligible to apply if the focus of their work is India.
3. An applicant can submit multiple entries in all the categories.
4. Applicant will show some proof of the pilot that has been undertaken.
5. If you are not able to submit your application through the online platform, please submit the application at innovexodisha@gmail.com latest by 28th Nov 2016.
1. Applicant Information
Please complete the following general information to provide the necessary applicant background information.
Applicant Name (First and Last):
Your answer
Date of Birth (MM/DD/YYYY):
MM
/
DD
/
YYYY
Name of the Startup:
Your answer
Type of the Organization:
(Ex: Private Ltd.,LLP,Proprietorship,Partnership,To be Incorporated.)
Your answer
Phone number:
Your answer
Email Id:
Your answer
Correspondence Address:
Your answer
City:
Your answer
State:
Your answer
Pin Code:
Your answer
Country:
Your answer
Team Members Name (if any):
Your answer
How did you come to know about YI INNOVEX @ MIO ? :
Your answer
2. Startup's Information
Please complete the following information to provide the necessary information on your existing organisation.
Stage of implementation (Kindly highlight the appropriate option)
Required
Date of Incorporation/Launch of the organization
MM
/
DD
/
YYYY
Current Location
Your answer
Title of Project
Your answer
Website (if any)
Your answer
Sector
Required
Any prior experience in the sector (s) targeted:
Your answer
States (s) / Geographies Targeted:
Your answer
Do you cater to any of these four groups?
3. Proposal Information
Please complete the following information to provide the necessary information on your proposal.
Brief about your organization.
What problem/gap does your organizations addresses through this project? (Max 100 Words)
Your answer
Market opportunity
Who are your target beneficiaries/customers? Provide information on number of people trained & vocational course experience provided with. How many placements have you managed to achieve so far? (Max 50 words)
Your answer
Solution
What were the activities that you have conducted so far? Provide us some proof of pilot of your work. Share information on what you have done so far. Share documents of the recognition that you have achieved. This can be any award that you have received, any newspaper clippings, web link capturing your work etc. (50 Words)
Your answer
Uniqueness
What is unique about your work that will differentiate you with others and will result in providing a better opportunity to the target customers? (Max 50 Words)
Your answer
Technical Expertise
What is the motivation to pick up this project to work on? Do you have prior experience in skill building and leading a business? (Max 50 Words)
Your answer
4. Quick FAQs
Please complete the following information to provide the necessary information on your proposal.
Share the video URL of your innovation.
http://
Your answer
What are you selling/offering to sell in the next year? (50 Words)
Your answer
What monetization models are you using / will do to test your product or service. (50 Words)
Your answer
Do you plan to raise money in the future? If so how much and when? (50 Words)
Your answer
Declaration
Required
Contact
Any questions? Please contact:
Tapendra N Senapati, Santosh Pradhan
Email: innovexodisha@gmail.com Tel: +91 75049 – 39039,+91 97761 41751
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