GBV Hackathon Participant Sign Up Form - 3rd October - 11th October 2020
Do you have a desire to be a change agent and work towards building a solution that can help change the world? If the answer is yes, then we encourage you to sign up to the Build Community Hackathon, hosted by the U.S. Consulate General Johannesburg and Silicon Cape.

You can read more about our past hackathon : https://buildcommunityhackathons.co.za/ and follow #GBVhackJHB

Please only complete the form if you are able to attend all sessions on
Saturday 3rd October 08:30 - 17:00
Sunday 4th October 08:30 - 13:00
Sunday 11th October 08:30 - 11:30 (Final Presentations)


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Name
Surname
E-Mail
Contact Number
Are you entering as a team or an individual?
Ideally it is easier if you enter as a team but we will gladly connect you to other attendees who are individuals that you can then combine forces with to create your own team. 1. A team that wins will have to split the prize money. 2. ALL team members will need to sign up as individuals. (Please also list the names of the team members in the next question)
Clear selection
If you are signing up as a team : Who is your team lead and do you have a team name?
If you are the team leader - please include all the names of your team mates
Occupation
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Other - Please specify
If you marked Other above, please let us know your occupation
Sector
What sector are you in? ie Healthcare, Medical, Agriculture, Gender Studies etc
Location
To enter this hackathon you are required to be based in Gauteng, North West and Free State Provinces. Please insert your address of residency.
Do you have good internet
As this is a virtual hackathon, we want to encourage you to only sign up if you have access to stable internet. Please confirm if you have access to stable internet.
Clear selection
If you are a winner, will you allow us to use your picture for publicity purposes?
Clear selection
Do you have any questions?
We are looking forward to hosting you for this virtual hackathon and know that you might have some questions for the organisers. Please list them here and we will do our best to reach out to answer them.
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