Research, Innovate and Emerge application form

Please complete the details below to apply for the Research, Innovate and Emerge programme.

Name

First name

Last name

Email

Educational Qualification

Phone

Name of your organisation

Registered Business Name/Company Number (as per Companies House)

Please provide the registered location of your organization, including the name of local authority/council.

Please write in 100 words about your innovative solution and R&D priorities.

Please write in 100 words about the R&D support you require from the academic experts of Brunel University of London.

How many full-time staff are employed currently in your organisation?

Can you provide evidence of £300,000 Investment / Expenditure during last financial year?

YesNo

Can you commit to attend 3 day workshops(as per the schedule) and receive mentoring support (up to 5 hours) to develop organisational R&I strategy?

YesNo

How did you hear about this Programme?

Declaration 1:

The above statements are true to the best of my knowledge

Declaration 2:

I authorize Brunel University of London to store my contact details and communicate with me in accordance with the General Data Protection Regulation (GDPR) and Brunel University's data protection policy.

Declaration 3:

I will report at the venue of the workshop as per the schedule; I will be available during the 3 days of workshop; I shall complete the required tasks as part of the RIEm workshop.