NATIONAL INNOVATION AWARD - 2018
ABOUT YOUR SELF
YOUR EMAIL ADDRESS *
LAST NAME *
As it appears in the ID or Passport
FIRST NAME *
As it appears in the ID or Passport
OTHER NAME
Your ID Number *
Insert a copy of your ID *
Required
Insert your Passport-size Photograph *
Required
Mobile Number *
HOME COUNTY *
YOUR AFFILIATE INSTITUTION
( eg. university, innovation /incubation hub, Research Institution or TVET institution)
Name of the Affiliate Institution, Address and Telephone Number *
Upload a Letter of Recommendation from your Affiliate Institution (University, Incubation Centre or Innovation hub, Research Institution or TVET Institution) *
Required
Insert Your Resume/ Brief CV (max. 2 pages) *
Required
ABOUT THE INNOVATION
Describe your innovation based on the provided guidelines.
Title of Your Innovation *
Indicate the category / area of your innovation: (1) Health; (2) Housing Technologies and Environment; (3) Agriculture, food technologies and Food Security; (4) Energy Systems; (5)Manufacturing, Engineering and ICT *
Give a brief description about your innovation (Maximum of 100 words) *
Define the problem that the innovation seeks to address in line with the national development Agenda (Max. 100 Words) *
Select the sustainable challenge that your innovation seeks to address? *
Required
What is the stage of your innovation? *
Is Your innovation protected? *
If protected, please give the type of Intellectual Property protection and certificate number
What are the lessons that you have learnt from your innovation journey that may benefit your peers? (max 150 words) *
YOUR BUSINESS PLAN
(This section is about market, scalability of the innovation (good or service) and the socio-economic impact)
One line Pitch (Max. 50 words) *
(i.e. what it is, who is it for, how it will change the world)
Give a short description of your business idea/plan (max. 150 words) *
Have you ever obtained a grant or raised commercial investment capital before? *
Required
If yes, briefly describe the source, amount and the year.
Briefly describe the target market for your innovation and what are your perceived needs for your customers (Max. 100 Words) *
Describe the major risks and challenges that you will have to overcome in taking the innovation business plan/idea forward (100 Words) *
Describe the expected Socio-economic impact of your innovation (Max. 70 Words). *
DECLARATION
This is to declare that:
1. The information I have provided is accurate and is my original work;
2. I understand that if I participate in the programme, it is entirely my responsibility to provide all the relevant and mandatory documents.
3. That I will allow the Kenya National Innovation Agency to share the provided information with its partners and stakeholders for the purposes of preparing for the Programme, monitoring, evaluation and reporting.
5. I am / shall be affiliated to an Institution for purposes of product development and/ or innovation commercialization.
6. I understand that in case I am declared a winner for the programme:
a)The Award will be used for purposes of innovation development or seed fund for commercialization;
b)The Award will be channeled through my affiliate institution;
c) I shall provide progress and final reports as per the requirements of KENIA through my affiliate institution.
By ticking the check box *
Required
YOUR FULL NAME *
DATE *
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