TERMIS-WC 2018 BPC Round 1 Submission Form
Please complete the form below with your company information and team contact details. The application document should be attached to this form once completed.
Team Name *

Logo *

Please attach in .png or .jpg file, minimum. 300 dpi, minimum. 1,000 px on longest dimension
Company status, if registered, in which Country: *

It is not mandatory for a team to have registered its company. Companies that have been registered for over two years (on the date of the Round 1 deadline) are ineligible (refer to Terms & Conditions).
Tagline *

Briefly describe the vision of the company in a few words, e.g. “Transforming Diabetes Care” (max. 50 characters).
One-sentence pitch: *

Concisely pitch the challenge and solution offered by the company (max. 350 characters).
Contact Details

Please enter details for the team member that will act as Team Representative. They will receive all relevant communications regarding the application.

Round 1 Application form

Please attach the completed application form *

both .docx or pdf are acceptable
Additional supporting information (optional)

Append one additional A4 .pdf file to include graphs and figures (you should include short captions but no extensive text). You should make reference to these figures in the body of your application form.
Thanks {{answer_ViTYovFWiKW9}}! You will receive an email within three working days confirming successful receipt of your application. Good Luck!
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