CERI Concept to Creation Application

1
Name* This field is required.
First Name
Last Name
2
Email* This field is required.
3
Phone Number* This field is required.Your best mobile number, in case we need to contact you regarding your application.
Please enter a valid phone number.
4
Before you apply, would you prefer a brief discovery call with Kristen, our Program Lead?
Yes - I have a couple of questions
No - I am ready to apply
5
Book a time that suits you.
6
Please indicate the scholarship you would like to be considered for:* This field is required.
None
Student Scholarship ($330)
Founder's Scholarship ($330)
Part-Time Scholarship ($440)
Full-Time Scholarship ($550)
Murdoch Scholarship
7
Did someone refer you to CERI? Please enter their name here
First Name Last Name
8
Dietary Requirements
Vegetarian
Vegan
Gluten Free
Kosher
Halal
Tree Nut Allergy
Other
9
Are you involved with a university?* This field is required.
Yes
No
10
Fill in the following blanks that fit you best:
Currently, I am at * where I am a * in the field of *
11
Whether now or going forward, where do you see your university career taking you?* This field is required.
advanced materials
Advanced manufacturing
AI
BioTechnology
Blockchain
Quantum computing
Robotics
Photonics
Electronics
green energy
Agriculture
Life sciences
Pharmaceuticals
Health
Well-being
Education
Finance
eCommerce and retail
Technology
Digital Technology
12
Do you have your own company or a Start-up idea you are pursuing?* This field is required.
Yes
No
13
Do you work for a large organisation where you are tasked with innovation?* This field is required.
Yes
No
14
If you're one of our associates from Mannkal Economic Education Foundation, check below.
I am a Mannkal Scholar.
No, I am not a Mannkal Scholar.
15
Does your company fall into some of the categories listed below?* This field is required.
advanced materials
Advanced manufacturing
AI
BioTechnology
Blockchain
Quantum computing
Robotics
Photonics
Electronics
green energy
Agriculture
Life sciences
Pharmaceuticals
Health
Well-being
Education
Finance
eCommerce and retail
Technology
Digital Technology
16
Fill in the following blanks that fit your venture best:
Hello! I work for Company Name * . So far we have received around * in revenue and investment. We have been operating for number of months months and have a team size of team size * . Currently, the stage we are at is best described as * . Our current biggest problem revolves around * .

You can find more about us here: Website/LinkedIn .
17
How many of your team members will be joining you in the program? * This field is required.Solo founders are eligible to apply however we do encourage teams of 2+. This is simply so that the workload is distributed. Please note that 80% minimum attendance is required to graduate. A team will be granted attendance as long as the majority of team members are present.
18
Now we have some of the details about your company ironed out, its your turn to tell us what your company does. Let's start by finding out what problem you are solving?* This field is required.
Huge
Large
Normal
Small
Ok
Ok
19
Next, tell us a little more about WHO you are solving the problem for? What is the defined market or customer segment?* This field is required.
Huge
Large
Normal
Small
Ok
Ok
20
We are looking for early stage entrepreneurs who are willing to put the work in to build their business and must be able to commit at least 2-3 hours per week for the program content (plus the Thursday evening session). Graduation will also depend on minimum 80% attendance at class sessions.
I confirm that I understand and can commit the time and effort
I cannot commit the time and effort
21
Thank-you for your responses so far. The last thing we want to cover is why you're applying. Please give a brief answer about who you are, what made you apply Concept to Creation and what you are hoping to gain from the program.* This field is required.
Huge
Large
Normal
Small
Ok
Ok
22
Persona
23
Deep Tech
Should be Empty: