Printable Document of the Application Here

Innovate Salone
An Initiative of Global Minimum
73 Siaka Steven Street
Freetown, Sierra Leone
[email protected]
+23276308337
School Name & Project Name:
....................................................................
.....................................................................
School Category:
€ National
€
Provincial
€
District
School Location:
€ Urban
€
Rural
€
Other
€
Private
2015 INNOVATE SALONE PROGRAM APPLICATION FORM
Innovate Salone
The Innovate Salone “A de mek am” Challenge empowers local youth to create and implement
their own solutions to pressing problems in their communities. Our vision is to expand a culture
of innovation and self-efficacy that can help drive economic, social and human development in
Sierra Leone.
Innovate Salone is independently funded by Global Minimum Inc., individuals, public and
private institutions. Donated resources help with the organization of the program, support and
implementation of the best ideas and maintaining a network of innovators and social
entrepreneurs in Sierra Leone.
The Program
Youth are encouraged to work in teams of 2 - 3 for the Innovate Salone program. Up to 10
teams will be selected by an acclaimed panel of international and local judges for a fully-funded
2-month program of workshops, field-trips, mentorship and seed-funding to produce a prototype
of a solution for a well-defined local problem.
Teams will need to provide details of how the prototype will be developed and why they are well
suited to accomplish the project. Each team will be assessed based on their project proposal
and recommendation from the school nominating them. At the end of the application cycle, up to
10 finalist teams will be selected as participants.
Project Submission & Finalist Announcements
To apply, each team must submit their application form by June 27th, 2015 to the email
address [email protected], or mail the application to:
Innovate Salone: C/O Mahmoud Javombo
73 Siaka Steven Street
Freetown, Sierra Leone
For questions regarding the application, contact the following people in your respective
province/city/district/town;
Freetown (South) – Mahmoud Javombo | 076 308 337
Freetown (West) – Ibrahim Tucker | 078 290 685
Makeni (North) – Morrison Yayah Kamara | 076 955 440
Kenema (East) – Christopher Mansaray | 076 867 925
Selected participants will be announced on July 17th, 2015.
Attached to the application must be a list of team members, a list of advisers, and a
recommendation letter from a school.
The proposal should include all of the following:
1.
2.
3.
4.
5.
6.
7.
8.
Introduction: A brief overview of your project. (Maximum 100 words)
The Challenge: What is the challenge/problem that your team is trying to solve through this
innovation competition? (Maximum 100 words)
Problem Motivation: Why is this problem important? (Maximum 150 words)
Proposed Solution: How are you planning to fix this problem? What is your approach? Is
your approach scalable? (Maximum 250 words)
Other Solutions: What other community solutions which address this problem? Is there
anything similar to your solution? Please list them here. (Maximum 250 words)
Detailed Budget: What would the costs be to completing your project?
Plan of Action: What steps are you planning on taking to make this project a reality?
Resources needed: Please list resources needed to accomplish your project. This should
include resources you currently have and other resources you will require.
The deadline to submit a proposal by email, mail, or in-person is June 27th, 2015, by
5:00PM.
You may use the below form for your application to this competition. Alternatively you can copy
the questions and answer them in a separate document. Feel free to attach additional
information if necessary. Please fill out all sections of this form.
APPLICATION FORM
1: Team members: Please list the name and class of all team members and their assigned
roles, i.e. Team Leader, Accountant, Designer, Project Assistant.
Name
Role
Gender
Birthdate
Grade
Phone
Email
*Please note that each team has to have a team leader
2: Team Mentors: Please list the name of teachers or faculty members that will serve as
mentors or contact person. Include phone and e-mail.
Name
Designation
Phone
Email
3: Team Contact & School Information: Email (if any), Telephone number and School
Address:
4:
€
€
€
€
€
€
How did you hear about Innovate Salone? (Please tick all that apply.)
Facebook
Another Student
Teacher/ School Faculty Member
Poster in School
School Announcement/ Presentation from Innovate Salone Representative
Other: _______________________
5: Introduction: Please provide a brief overview of your project. (Maximum 100 words)
Include the sector of your project as well:
€ Agriculture/Food
€ Engineering
€ Science
€
Arts & Design
€
Environment
€
Civic Media/Visual Arts
€
Health/ Healthcare
€
Education
€
Telecommunications
€
Energy
€
Water & Sanitation
€
Other (Please
describe):
6: The Challenge: What is the challenge (problem) that your team is trying to solve through
this innovation competition? (100 words)
7: Problem Motivation: Why is this challenge important to solve? (150 words)
8: Proposed Solution: How are you planning to address this challenge? Where will you do it,
who will you work with, how will you engage your community? Describe the model you want to
design. Include or attach a diagram/illustration or photos of the project if possible. (250 words)
9: Other Solutions: What are other community solutions which address this problem? How
does your project differ? Please briefly describe them here. (250 words)
10: Detailed Budget: What would the cost be to complete your project? Attach additional
materials if needed.
Material
Description
Quantity
Cost
e.g Plastic pipe
PVC plastic pipe
3 x SLL 1800
SLL 5,400
Total
11: Plan of Action: What steps are you planning on taking to make this project a reality? What
is the timeline in which you will finish the design? Include goals that your team has set for each
week to complete your project.
12: Resources needed: Please list resources needed to accomplish your project. This should
include resources you currently have and other resources you may require.
13: RECOMMENDATION/ATTESTATION FORM
This form must be filled out by the Principal or Deputy Principal of the school.
Please provide a reasonable recommendation for the team. Please indicate why you think this
team should be nominated to receive funding for the Innovate Salone competition. Please feel
free to attach additional pages if necessary.