Greetings!

Thank you for your interest in the 
#LeanStartup academy,
which will take place on October 19th and 20th as part of eHealth Forum Athens 2017.

Please use this form to provide information about your company and solution. It will be reviewed by a selection committee to draft the final list of participants. ALL questions require a response.

Below are a few reminders about the academy:

Calendar:
Application deadline: September 13th 
Confirmation of 10 participants: September 18th
Online training (10 weeks): September 25th - December 1st
Live session: October 19th - 20th / 09:00-18:00 eHealth Forum Athens 2017

10 participants will be invited to attend the training.

Eligibility criteria : headquarters in Europe + commitment to attend the physical event + commitment to follow the 10 weeks online training and follow up period on the Lean approach. 

Selection criteria: unique value proposition / scalability / commitment.

IMPORTANT: 
Typeform is very cool BUT does not let you save and finish your application later. So we highly recommend saving your responses in a separate word document. Just in case.

If you have any questions about the #LeanStartup academy, please email Dario Mazzella: d.mazzella@meta-group.com.
start
 
Company name / Organisation *

 
Name *

 
Surname *

 
Job title *

 
Phone

Add the code
 
Company headquarters (Country) *

 
Web *

 
LinkedIn

 
Twitter

 
Are you available to attend the event in Athens on October 19-20 and to commit for a 10 weeks on-line training and follow-up period on the Lean approach? *

     
 
SHORT DESCRIPTION OF PRODUCT/SERVICE  WITH EMPHASIS ON UNIQUENESS OF THE BUSINESS/INNOVATION LEVEL (max 500 characters) *

 
INNOVATION & COMPETITIVE STATUS (max 1000 characters) *

What is innovative about your product/service? What are your competitive advantages? How do ICT technologies drive you to success?
 
MARKET & CUSTOMERS (max 1000 characters)
*

What are the needs you address? Who are your customers? How do you reach them? What are key activities generating revenue and what is your revenue?
 
TEAM (max 1000 characters) *

What skills do you have in your team that are relevant for this product/service?
 
RESOURCES AND COSTS (max 1000 characters) *

What are your key resources? What are your costs?
 
FUTURE OF THE COMPANY (max 1000 characters)
*

Dreams and ambitions of your company? What are your nexts steps? And what do you need to succeed?
 
MARKET & NETWORKING *

Please score your potential for improvement. This will help us to evaluate your motivation and how eHealthHub could meet your needs.





 
MARKET & NETWORKING (max 250 characters) *

Explain  what would be your next challenge in this field
 
TECHNOLOGY *

Please score your potential for improvement. This will help us to evaluate your motivation and how eHealthHub could meet your needs.





 
TECHNOLOGY (max 250 characters) *

Explain  what would be your next challenge in this field
 
FINANCING *

Please score your potential for improvement. This will help us to evaluate your motivation and how eHealthHub could meet your needs.





 
FINANCING (max 250 characters) *

Explain  what would be your next challenge in this field
 
Have you already been the beneficiary of external finance? (max 250 characters)
*

If yes, please indicate type and amount (eg. public funding, private funding, accelerators/incubators)
 
Attachment (optional)

Submit any document you would like to share (eg. pitch deck, one pager, executive summary) in order to help us to better understand your company/idea
 
Data protection *

By submitting this form, you allow us to keep the information provided in our database, in order to send you information about the eHealth HUB project.

The details you submit through our website or in any other manner will be included in a file held by TICBioMed, Tecnologías de la Información de la Región de Murcia. You can exercise your rights of access, amendment, erasure and objection by contacting lopd@ticbiomed.org

     
Thank you for submitting your application!
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