BIOPAD SEED FUND TEMPLATE by RobbiePaul

VIEWS: 7 PAGES: 2

									APPLICATION TEMPLATE
     [Please complete the following template as comprehensively as you are able to. Where you are unable
     to provide information please insert N/A (Not Applicable)]

1. APPLICATION DETAILS

BUSINESS OR PROJECT DETAILS:

NAME OF COMPANY, OR LEADER
OF PROJECT:

POSTAL ADDRESS :


PHYSICAL ADDRESS :
(If it differs from postal address)



CONTACT PERSON :

INSTITUTION :
(if applicable)


TELEPHONE NO.                                            FAX NO.

CELL NO :

EMAIL ADDRESS :

DATE OF SUBMISSION :

INDUSTRY SECTOR (Mark with an X)

HUMAN Oncology                            HUMAN Parsitology         HUMAN Infectious diseases
ANIMAL Oncology                           ANIMAL Parsitology        ANIMAL Infectious diseases



FINANCING OBTAINED TO DATE :


MAIN SOURCES :


REQUIRED FINANCING :
(If applicable, however, this programme does not
provide funding)



CONFIDENTIAL                                                                                          1
2.      APPILCATION BRIEF: MAXIMUM 3-4 PAGES Arial 11pt
        [Please use the headings provided and answer the questions posed to complete the application
        process.]


2.1       THE BUSINESS OPPORTUNIY / CASE: (½ page)
2.1.1     What is the business case? In other words what is the value proposition? (We are looking
          for a compelling reason why this is not currently done and what your advantage above
          the current market leaders would be.)

2.2       THE PROJECT / VENTURE TECHNOLOGY: (¾ page)
2.2.1     Describe what the new Technology/Product does. Highlight its novel features and
          attributes and how it provides advantages when compared to the current
          Technology/Products in the market.
2.2.2     Have you done a techno economic analysis? Show the crux where your technology /
          project perform better economically than current products in the market.
2.2.3     What is the technology’s stage of development? (Research/Development/Pre-
          Market/Early adopters/Main market/Late adopters)

2.3       THE TEAM: (½ page)
2.3.1     Describe the team and their functions / capacities within the project / venture. Are there
          gaps?
2.3.2     What are their qualifications and experience? (no CV’s required just 1 liners)

2.4       INTELLECTUAL PROPERTY (IP): (¼ page)
2.4.1     Describe the project/venture’s intellectual property status, and the actions to be taken in
          future? (Do you have freedom to operate?)

2.5       COMMERCIALISATION STRATEGY: (¾ page)
2.5.1     What is the commercialisation (technology to market) strategy? Give specific details of
          how you will implement this.
2.5.2     Describe the market segment or niche you target. Be specific.

2.6       FINANCIALS: (¼ page)
2.6.1     Give a high level overview of your financial status or needs for the next 3 years.

2.7       EXPECTED OUTCOME: (½ page)
2.7.1     What is your biggest challenge to being successful?
2.7.2     Please provide information about your needs and challenges not addressed in this
          document, and rank them according to their importance.




CONFIDENTIAL                                                                                           2

								
To top