2014-2015 WISE ACCELERATOR
APPLICATION FORM
EDUCATION & TECHNOLOGY
INSTRUCTIONS
Please read the 2014-2015 WISE Accelerator Guidelines carefully before filling in your application.
Please note that if you are shortlisted, you will be required to provide any kind of documents that may
contribute to the assessment of the project:
- A Business Plan or a project proposal;
- Certification, if you are certified by an external auditor;
- Other assessment of measurable impacts and outcomes, if you have any;
- Short biographies or CVs of the two project representatives.
To apply for the 2014-2015 WISE Accelerator Program, this form should be submitted online by
Monday, September 8, 2014 at 16h GMT at http://www.wise-qatar.org/wise-accelerator.
Please note that applications received after that date will be considered for the 2015-2016 Program.
Should problems be encountered in completing the form, please contact the WISE Team by email at
accelerator@wise.org.qa
CHECKLIST
Please review the checklist below to make sure that your application is eligible.
I have completed this application form in English.
I have read and agree to the 2014-2015 Guidelines.
I have included contact details of two valid referees.
This project has not been presented by another member of my team/partner organization.
I have given clear evidence of all fields and selection criteria listed in this form.
PLEASE SAVE THIS FILE IN WORD FORMAT <projectname.doc>
AND SUBMIT IT AT www.wise-qatar.org/wise-accelerator by September 8, 2014, 16.00 GMT to
apply for the 2014-2015 WISE Accelerator program.
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PART 1: GENERAL & ADMINISTRATIVE INFORMATION
DETAILS OF THE PROJECT
Name of the project:
Project website:
Education sector: click here
Other:
Year the project started:
Number of team members:
Project budget (current levels of funding and/or investment): click here
Indicate how the project has been funded to date:
Project revenues, if applicable: click here
Estimated stage of development (N.B. more information on each stage on the Guidelines): click here
Please explain the reasons why you placed your project in this stage:
DETAILS OF THE ORGANIZATION
Name of organization:
Location of headquarters (city/country):
Legal registration/license number:
Total number of employees: click here
Type of organization: click here
Non-profit organization
Organization revenues: click here
Other:
For-profit organization
If over US$500,000, please specify:
DETAILS OF THE PROJECT REPRESENTATIVES
TEAM MEMBER 1
Title:
First name(s):
Family name/Surname:
Position/role in the project:
TEAM MEMBER 2
Title:
First name(s):
Family name/Surname:
Position/role in the project:
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PART 2: PRESENTATION OF YOUR PROJECT
OVERVIEW
Describe the main objective of your project (in one sentence):
Briefly explain your project:
What evidence can you provide that helps us understand the innovative aspects of your project?
EDUCATIONAL CONTEXT
State the educational and social challenges that your project addresses (150-300 words):
AUDIENCE AND REACH
Explain who the beneficiaries and/or clients of the project are (direct and indirect):
Number of beneficiaries and/or clients to date:
Reach of the project: click here. Please indicate countries where the project operates (optional):
How do you estimate your project’s impact to date?
CHALLENGES AND OBJECTIVES
Explain the challenges your project is currently facing:
What are your objectives in the next two to five years?
What are the obstacles you foresee for the project to achieve impact at a larger scale?
Why did your organization apply for the WISE Accelerator?
Why is it the right time to join an accelerator programme and what do you expect from it?
Have you ever joined an incubator or accelerator? click here If so, which one?
NEEDS AND SUPPORT
What do you need to achieve your goals and objectives?
Please select up to three fields where the WISE Accelerator could contribute to developing and scaling
up your project, classifying them from 1 to 3:
Business Plan and Strategy Development
Organization and Planning
Financial Management
Human Resources Management and Personal Development
Content and Curriculum
Communication and Marketing
Operational Implementation and/or Technical Assistance
Legal Assistance
Other, please specify
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PREPARING THE FUTURE
Please provide us with key information on your financial planning for the next two years:
Explain why the project is of potential interest to investors, donors and/or clients:
Please list the investors, donors and/or clients you would like to target:
If selected, how do you see your project at the end of the one-year program?
If selected, how do you see your project two years from the end of the one-year program?
PART 3: EXTERNAL REFERENCES / SUPPORTERS
Contact details and complete information on two external referees (e.g. former donors, local governments, other
NGOs, etc.) must be included in all applications. The referees should have no family relation to the leadership of
the applicant organization. Failure to include these contact details will automatically lead to the rejection of the
application. WISE reserves the right to contact the referees at any stage during the evaluation process.
REFEREE 1
Full name:
Institutional title/role of person endorsing this application:
Organization:
Email address:
Phone number:
Relation to project representative (in one sentence):
REFEREE 2
Full name:
Institutional title/role of person endorsing this application:
Organization:
Email address:
Phone number:
Relation to project representative (in one sentence):
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