SCALEUPWA 2023 SERIES
Please complete the following application form to register your interest to participate in the Triangle Innovation ScaleUpWA 2023 programme. Once received, you will be contacted to discuss your interest and ScaleUpWA will help you build your capabilities to transform your business and engage in the ASEAN market.
CONTACT DETAILS
*
First Name
Last Name
Contact Phone Number
*
(include area code)
Email
*
example@example.com
COMPANY NAME
*
BUSINESS ADDRESS
*
Street Address
Street Address Line 2
City
State
Post Code
WHAT PRIMARY INDUSTRY SECTOR ARE IN?
*
Agri/Food
Construction
Defense
Health
Finance
IT/Coms
Manufacturing
Mining
Oil & Gas
Professional Services
Transport
Other
TELL US ABOUT YOUR BUSINESS
*
ANNUAL TURNOVER
*
NUMBER OF EMPLOYEES
*
ARE YOU EXPORTING AT PRESENT?
*
Y
N
(Y OR N)
IF YES,
List markets currently export to.
WHAT MARKETS WOULD YOU LIKE TO EXPLORE?
*
BRIEFLY OUTLINE THE STRATEGIC OUTCOME(S) YOU WOULD LIKE TO ACHIEVE IN THE NEXT YEAR
PLEASE INDICATE IF YOU APPLYING FOR A SCHOLARSHIP TO THE PROGRAMME AND FROM WHOM?
*
No Scholarship
Yes - City of Canning Scale Stage - City of Canning is offering a scholarship up to 100% of the delegate fee to approved applicants who must be a resident and/or business owner/operator in the City of Canning.
Yes - Food Innovation Precinct Western Australia (FIPWA) – Shire of Murray is offering a contribution of 50% from the FIPWA Enterprise Support Program (Guidelines are available at https://fipwa.com.au/enterprisesupportprogram/)
Yes - DPIRD is offering a scholarship to the ScaleUpWA programme for approved applicants from the Agri/Food industry of 50% of the delegate fee to assist them to transform their businesses to get scale, create and capture value and position the business for harvest.
IF YOU ARE SUCCESSFUL IN RECEIVING ANY OF THE SCHOLARSHIPS ABOVE, DO YOU AGREE TO PARTICIPATING IN ALL SESSIONS OF THE PROGRAMME AND COMPLETING AN EVALUATION FORM AT THE END OF THE PROGRAMME?
*
Yes
No
IF YOU ARE APPLYING FOR THE CITY OF CANNING SCHOLARSHIP, PLEASE INDICATE IF YOU HAVE APPLIED FOR ANY OF THE OTHER CANNING BUSINESS MENTORING PROGRAMME SCHOLARSHIPS?
*
I have not applied to another City of Canning Scholarship Programme
I have applied to the City of Canning Seed Stage
I have applied to the City of Canning Start Stage
I have applied to the City of Canning Sprint Stage
I have applied to the City of Canning Sustain Stage
IF YOU HAVE APPLIED FOR THE FIPWA SCHOLARSHIP, DO YOU UNDERSTAND THATYOUR APPLICATION WILL BE CONSIDERED FOR 50% FUNDING FROM THE FIPWA ENTERPRISE SUPPORT PROGRAM?
*
Yes
No
Guidelines are available at the following URL https://fipwa.com.au/enterprisesupportprogram/
IF YOUR APPLICATION FOR THE FIPWA SCHOLARSHIP IS SUCCESSFUL, DO YOU UNDERSTAND THAT YOU WILL NEED TO MEET WITH FIPWA REPRESENTATIVE TO DISCUSS AFFILIATION OF YOUR PROJECT WITH FIPWA RESEARCH & DEVELOPMENT, INNOVATION AND/OR PRODUCTION ACTIVITIES?
*
Yes
No
*
REQUIRED
Please verify that you are human
*
Save
Submit
Should be Empty: