Somali Water Innovation Challenge
Application Form
Full Name
*
First Name
Last Name
E-mail
*
example@example.com
Phone Number
Please enter a valid phone number.
WhatsApp Number
Please enter a valid phone number.
Education Level:
Are you signing up as:
An Individual
A team
Startup Company
NGO
Established company
Government Entity
Other
Please write a short description of you/your team or start-up (100 characters)
At what stage is your water solution?
Idea
Prototype
Beta
Released
Other
What theme does your solution belong to?
Rural and pastoral water solutions
Urban water solutions
Behavioural related water solutions
Water recycling and purification
recharge aquifères(recharging underground water)
Tell us a few words about your solution/design?what do you present during the challenge?(200 characters)
Upload Media describing your design (e.g. slides, diagrams, experimental design, photo or any media type)
*
Upload a File
Drag and drop files here
Choose a file
Cancel
of
Or the link to an uploaded media describing your solution on (YouTube, dropbox, Vimo, google drive, etc)
How soon can your solution be prototyped or deployed?
Immediate
Mid
Slow
Other
Who do you think can help scale-up your solution?
Government
Private Sector
NGO
UN Agencies
Banks and financial institutions
Other
How much funding do you need to bring your idea/design/solution to life in Somalia
Low range (1000-2000$)
Mid range (2500-5000$)
Higher range(5000$ or more)
I am not sure
Other
Submit
Should be Empty: