Designathon Interest Form: INNOVATORS
NO LONGER ACCEPTING INNOVATOR APPLICATIONS
Please go to the Designathon CONTRIBUTORS application here: https://forms.gle/wXtYktkBjwnPuBzh8.
----
Thank you for your interest in being a INNOVATOR at the Designathon, which will be virtually hosted on December 4th. Please complete this form by November 7th at 5:00pm (EDT).

This Designathon seeks to inspire and develop creative solutions that end the HIV epidemic in the US among same gender loving men. If you have an existing solution that addresses the Designathon focus and want to further develop it with the help of experts, please click the button below to complete an application. We encourage people of all backgrounds and disciplines to apply.

This event aims to include people within and outside of the health space. Your solution can be for-profit or non-profit. At a minimum, you must have completed some initial research on your solution or have a prototype in progress. Applications will be reviewed by Firefly Innovations and affiliated partners, and up to 8 of the most promising innovators will be chosen to participate.  

Who We Are Looking For & Requirements:
 - Venture teams with at least an initial prototype that are looking to move into the next stages in order to launch or grow.
 - Co-founders with complementary talents: public health, science and engineering, tech development, business, finance, marketing, art and design, etc.
 - We encourage startups from any sector to apply. Startups can be nonprofit, for profit or hybrid ventures. There is no equity requirement.

How Your Application Will Be Assessed:
 - Innovativeness of the idea/concept: Represents a unique, innovative approach relative to a target population/location and demonstrates a clear understanding of the issue it seeks to address.
 - Public health impact and relevance: Likely to make a substantial preventative and population-based contribution toward the challenges it seeks to address.
 - Prototype development: The team provides a prototype that is representative of the desired solution and technology application (if applicable) that they may use, regardless of the ventures overall stage of development.
 - Quality of expertise: The team or individual has or can get relevant skills, contacts, industry knowledge, and experience. The venture team displays or has displayed complementarity in abilities among team members.
 - Action plan: Provides a clear description of approach and an understanding of required core competencies and key success factors.

If you're not working on a solution but you would still like to join the event to help shape an innovator's solution, please instead complete the Designathon Interest Form for CONTRIBUTORS here: https://forms.gle/wXtYktkBjwnPuBzh8.
Connectez-vous à Google pour enregistrer votre progression. En savoir plus
First Name *
Last Name *
Phone number *
Email address *
Please list your LinkedIn and/or web-based profile URL(s).
Are you working on this solution idea on your own, with a team, or with an organization? *
Organization
If you are working with a registered organization to advance this solution, give the name of that organization here. Otherwise, provide your personal organizational affiliation.
Position title at organization
Team
If you're working with a team, please list the first names, last names, positions, LinkedIn/profile URLs, and email addresses of all other team members.
What are the key strengths / areas of expertise you bring as a Designathon Innovator?
In which of the following (if any) do you have expertise?
May select multiple options.
What's your solution? *
Maximum 300 words.
Why are you well-positioned to deliver this solution? *
If you are working with a team or organization, share how many teammates you have, the roles of each teammate and why your team is well-positioned to deliver this solution.
What are your key barriers to advancing your solution idea? *
What is the scientific basis of your solution? Provide references as you see appropriate. *
Which of the following stages of development applies to your solution? *
If available, what type of prototype do you have?
Please describe your prototype in detail. Let us know if it is 3D printed, is developed with a prototype service like proto.io, is in beta launch mode, etc. Maximum 300 words.
If available, please provide a link to your prototype.
For example, you may provide a shareable link to a deck or a link to a website with more detail about your solution.
Anything else we should know?
Education level *
What is your age (years)? *
What is your gender? *
Are you Hispanic or Latino?
Effacer la sélection
What race(s) do you consider yourself to be?
Effacer la sélection
How did you hear about this Designathon? *
Envoyer
Effacer le formulaire
N'envoyez jamais de mots de passe via Google Forms.
Ce contenu n'est ni rédigé, ni cautionné par Google. Signaler un cas d'utilisation abusive - Conditions d'utilisation - Règles de confidentialité
Google Forms