Reverse Innovation Application Form

Noted: One person can only apply one time to one challenge only.

Please Select the Challenge You Propose to Address*
First Name*
Last Name*
Date of birth* DD-MM-YYYY
Phone Number*
LinkedIn Profile
Briefly Introduce Yourself*
(Explain your expertise in solving the problem)
Solution/Idea Title:*
Overview of Idea/Solution (minimum 400 words)*
Key Benefits (minimum 300 words)*
How did you hear about our Program?*