APPLICATION FORM
INL Incubation Program
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PROJECT NAME: *

 
PROJECT TEAM

 
Individual Information

 
Name: *

 
Surname: *

 
Date and place of birth: *

 
Nationality: *

 
Address: *

 
Phone: *

 
E-mail: *

 
Education level: *


 
Professional situation: *


 
Short CV *

(2000 characters)
 
Composition of the Project Team, organisation and team skills: *

(3000 characters)
 
PROJECT DESCRIPTION

 
What is the nature of the technology, innovation status and market application? *

(3000 characters)
 
Add a picture if necessary:

 
Did you request Intellectual Property? *

     
 
If Yes, what is the current status and type of IP requested?

(500 characters)
 
Detail the research work done at the origin of the innovation: *

(3000 characters)
 
What is the actual TRL level, what developments will be needed to reach the market, and how much time it will take? *

(3000 characters)
 
Do you have support from other institutions, namely Laboratories, Research Centers or Consultancy Services? *

(3000 characters)
 
Do you have partnership agreements, contracts and/or licenses?

(3000 characters)
 
PROJECT BUSINESS MODEL

 
Is the Company already established? *

     
 
If Yes:

 
What is the nature of the company?

 
What is the date of establishment?

 
What is the Corporate Structure (shareholders)?

 
If No

 
What is forecast date for company set up?

 
What is the desired legal nature of the company?

 
What is the expected Corporate Structure (shareholders)?

 
Have the members of the project team already established business (still active or not)? If so, who and which companies?

(2000 characters)
 
How do you see your business in the medium term (3 to 5 years)?

(3000 characters)
 
Gantt with the project main activities and results for the next 3 years:

 
Market analysis: What will be the positioning of your company in relation to the competition?

(3000 characters)
 
What public will target your product(s)/service(s), who will be your first customer and where are they established?

(3000 characters)
 
What are the identified suppliers? How will the production and distribution be organized?

(2000 characters)
 
PROJECT FUNDING

 
What will be the needed funds for the first 2 years of the company and how will you acquire them (personal funds, venture capitals, business angel)?

(1500 characters)
 
Detail the estimated budget for the next 2 years (salaries, general expenses, planned investments...)

(3000 characters)
 
When do you plan to generate income?

(1500 characters)
 
EXPECTATIONS FOR THE INCUBATION

 
Specify the expectations and need where INL Incubator can support your project/business? *

(2000 characters)
 
Place *

 
Date *

 
Confidentiality *

The information provided will be kept confidential and dissemination will be limited to the evaluation panel responsible of screening the applications.
     
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