Application form

1.0 Corporate Information

Is your company registered in Singapore?*

Yes
No

Company Name*

Date of Incorporation*

DD

MM

YYYY

Employee Size*

Legal structure of the company*

Private Limited
Public Listed
Government Owned/Linked

Primary Address*

Country

Phone Number*

Fax Number

Company Website

Business Size*

Kindly indicate your annual revenue range below

*Additional documents to corroborate the financial details above can be appended to this form.

2.1 Contact Person Information

Name*

Designation*

Mobile Number*

Email*

2.2 Secondary Contact Person Information

Name*

Designation*

Mobile Number*

Email*

3.0 Category

Category*

Product
Service & Solution
Organisation & Culture

4.0 Submission Summary

1. Name of Innovation*

2. How long has the innovation been commercialized? Please tick.*

12 months
18 months
>24 months

3. What is the distinctiveness of the innovation?*

4. Has the innovation generated any returns on investment?*

5. How does the innovation generate societal impact and solve existing problems in our society?*

6. Why is the innovation sustainable and can it be replicated?*

7. How practical is the innovation and why is it viable?*

8. Is the innovation supported by any institution? If Yes, please explain:*

5.0 Supporting Documents

(LIST below the supporting documents and materials you are submitting to support the project or program, i.e. brochures, photos, press clippings, etc.)

Attachments

Drop files here or

Application Fee (including 3% stripe processing fee)

Price: $2,060.00

Application Fee (including 9% GST + 3% Stripe Processing Fee)

Price: $2,245.40

Total

$0.00

IMPORTANT! A non-refundable Application Fee will be charged with every submission. This fee is to cover the administration and other costs that will be incurred. An additional processing fee of 3% for remittance is included. We will contact you soon for further briefing on the next steps moving forward.

Payment

Credit Card

MasterCard

Visa

Card Number Expiration Date Security Code Cardholder Name

6.0 Declaration

*

1) hereby declare that the information submitted herein and as supporting documentation are to the best of my knowledge, true and verifiable. I understand and agree that should any of the information submitted herein and / or any supporting documentation appended herein found to be factually incorrect or are designed to mislead the judges, my nomination will be null and void, and if I’ve been declared a winner, my award will be rescinded. I declare that I am not related to any staff of the Organizers or to any judges appointed by the Organizers (except normal business relationship, if any). I further declare that I have not attempted and will not attempt in any manner, monetary or otherwise, to influence the decisions of the Organizers and/or the judges. I also declare that my business and I have never been investigated for criminal or civil offences at any time in the past or present.

2) By submitting this form, you consent to the organizer collecting, storing, processing, and disclosing your personal data as needed for order fulfilment, customer support, marketing, and legal purposes, in accordance with the Personal Data Protection Act.

I Agree

Phone

This field is for validation purposes and should be left unchanged.

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