HealthTech Reimbursement Form

We're really excited you're planning on participating at HealthTech. To show our gratitude, we're willing to reimburse you for hardware you're using for your (awesome) project for up to $50.00. Please fill out this form to be eligible for our new program.

With <3,
The HackGTeam
Sign in to Google to save your progress. Learn more
What is your name? *
What is your email? *
Have you already submitted your application to HealthTech? *
What is the expected cost of your hardware purchase (with shipping)? *
What is your hardware purchase? *
Please briefly describe your project and how you intend to use the hardware (we will not expect you to stick to this project, we just like to get an idea of your ideas) *
Do you understand and acknowledge that your reimbursement is contingent upon proof of purchase within the time frame of February 1 - March 14, as well as a submission that passes initial screening at HealthTech? The screening is intended to ensure that projects were actually completed - you do not have to win any prizes, but we do want you to complete a project with the item we are reimbursing you for. *
Clear form
Never submit passwords through Google Forms.
This form was created inside of HexLabs. Report Abuse