Germinate Participant Form

Germinate Participant Form

Please fill out form below and submit your completed form before the Germinate workshop.
Please select the Germinate programme you will be participating in.
Name

First NameLast Name
Role/title
Email
What is your geographical location?
Select your region in New Zealand.
Please enter your location.
University or PRO name
Please enter your University or Research Institution name.
Area(s) of research expertise
Project name
Please provide details about the project you’ll be working on during the Germinate programme.

0/100

The statements below relate to how you approach innovation and commercialisation. For each statement, select the option that is most accurate for you.

Rows	Strongly disagree	Disagree	Neutral	Agree	Strongly agree
I have deep scientific knowledge and expertise in my area of research.
The end-user or customer of my research is at the front of my mind during a research project.
I thrive working with the uncertainty of innovative projects and can navigate unpredictable challenges.
Leveraging strengths within a team to create impactful innovation is important to me.
I would consider leaving academia to take the risk to pursue a startup if the opportunity was right.

The statements below relate to your experience of innovation and commercialisation. For each statement, select the option that is most accurate for you.

Rows	Yes	No	Unsure
I have experience working on one or more projects that have led to an innovation being commercialised.
I have previously engaged with industry stakeholders and potential customers about the application of my research in their organisations.
I have previously completed interviews with industry stakeholders and potential customers to understand their needs.
I feel confident engaging with industry stakeholders and potential customers to learn about how their needs relate to my research.
I am interested in learning about how innovation can be commercialised as a spinout or startup.

Please select your current level of understanding of the following topics related to innovation and commercialisation:

Rows	No knowledge	Limited knowledge	Some knowledge	Knowledgeable	Very knowledgeable
Intellectual property protection
Industry regulations
Marketing
Commercial strategy
Research commercialisation
Research spinouts
Startups
Entrepreneurship
Investment and capital raising

Please describe what you are hoping to get out of the Germinate programme. What does success look like for you?

0/100
Do you have any dietary requirements?
Please provide your dietary requirements.

Reporting Information

The following information is collected for reporting purposes only.

Please select your ethnicity, gender and age.

Rows	Ethnicity	Gender	Age
Reporting Information

What is your highest qualification?
Select the option that is most accurate for you.
What is the duration of your academic career?
Please enter the number of years below (or zero if you don't have an academic background)
How much total funding have you received for research over your career?
Select the option that is most accurate for you.
How many patents have you produced over your career?
Select the option that is most accurate for you.
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Germinate Participant Form

Reporting Information