Innovative Solutions Scheme Application Form

Country:

Individual Applicant:
Full Name:
Phone:
E-mail:
	(Please upload your CV in the Annexes)

Applicant Organization:
Name of the Organization:
Type of Organization:
Address:
Tel:
E-mail:
Website:
Contact Person:
Full Name:
Tel:
E-mail:

Title of the Innovative Solution:

At the development stage

Pilot stage

Tested/ Active

Other. Please indicate:

Do you have intellectual property rights for the product? Please elaborate on the status of permission to use the product.

You are strongly advised to follow this structure while describing your solution:

Background information
Description of the solution. What makes this solution innovative and how it works
Main stakeholders and beneficiaries
Activities
Outputs, outcomes and estimated impact of the project
Approximate costs of implementation
What are the factors that make this project successful?
Lessons learned and potential for replication in other countries

Name partners familiar with your experience in this sphere. Provide contact details.

Provide available weblinks and resources with the information on your previous and current activity, on implementation of the solution submitted and other relevant information.

Please upload here any additional files in support of your application.

File size should not exceed 5MB.
Allowed formats: doc, docx, pdf, txt, xls, xlsx.