SHINE Partners’ Application Form April 19, 2018 * is the required field. Partner Type Personal or Organization PersonOrganization Organization Details Leagal name of your organization Organization name Government OrganizationCompanies Seeking Innovation SolutionsCompanies Seeking Advertisement Opportunity Venture Capital OrganizationResearch and Technological OrganizationUniversity and Other Tertiary OrganizationStudent or Alumni AssociationsInnovation Prescient / HubResearch or Innovations GrantsVenture LawConference Venue ProviderOther Which best describes your organization Type of Organization please specify Other Organization Type Core business or technology areas of your organization short description Location Location of your organization City Province, DC, or empty State AustraliaP.R.ChinaUnited StatesCanadaUnited Kingdom-----AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntigua and BarbudaArgentinaArmeniaArmeniaArubaAustraliaAustriaAzerbaijanAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaireBosnia and HerzegovinaBotswanaBouvet Island (Bouvetoya)BrazilBritish Indian Ocean Territory (Chagos Archipelago)British Virgin IslandsBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCongoCongoCook IslandsCosta RicaCote d'IvoireCroatiaCubaCuraçaoCyprusCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFalkland Islands (Malvinas)Faroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly See (Vatican City State)HondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKazakhstanKenyaKiribatiKoreaKoreaKuwaitKyrgyz RepublicLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyan Arab JamahiriyaLiechtensteinLithuaniaLuxembourgMacaoMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNetherlands AntillesNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorthern Mariana IslandsNorwayOmanPakistanPalauPalestinian TerritoryPanamaPapua New GuineaParaguayPeruPhilippinesPitcairn IslandsPolandPortugalPuerto RicoQatarReunionRomaniaRussian FederationRwandaSaint BarthelemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint Maarten (Netherlands)Slovakia (Slovak Republic)SloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSpainSri LankaSudanSurinameSvalbard & Jan Mayen IslandsSwazilandSwedenSwitzerlandSyrian Arab RepublicTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkeyTurkmenistanTurks and Caicos IslandsTuvaluU.S. Virgin IslandsU.S. Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUruguayUzbekistanVanuatuVenezuelaVietnamWallis and FutunaWestern SaharaYemenZambiaZimbabwe headquarter location Country of organization Collaboration preference In what way to collaborate with SVSIC Provide GrantsInvest in Your Favoured Start-up teamHost and Financially Support Overseas Innovation Ecosystem Trip for Your Favoured Start-up TeamProvide Financial Support to SVSICAdvertise Your Company via SVSICProvide Key Notes SpeechesProvide Expert in Your Chosen Technical AreasFuture CollaborationOther choose the most relevant one please specify Technology Field biomedicineinformation technologyresource and environmentoptical mechatronicsnew materialsnew energy and energy efficiencyagricultural technologyother advanced technologies You selected Provide Expert in Your chosen technical areas Please specify you selected other advanced technologies Other Future Collaboration please describe your collaboration Future collaboration Other Collaboration please describe your collaboration please describe it Other collaborations Stage of Collaboration You selected a support type that provide financial assistance IdeaAngelacceleratorAnyOthers Planning to support which stage of startup What Stage of collaboration Amount of Financial Support including sponsorship, investment to successful applicant, etc. $50,000 and more$10,000 - $50,000$5,000 - $10,000$2,500 - $5,000$1,000 - $2,500$500 - $1000Less than $500none In australian dollars Main contact person represent or authorized to represent an organization MrMrsMissMsProfDrCrLadyLordSir Title First name Middle name Last name you will receive further information through it Contact Email e.g. +61 2 12345678, Country-code area-code phone-number Contact Number Employed by Organisation/Company Professor, Director, CTO, CEO, Investor, Ph.D student, Master candidate ... Designation/Position