SSIP Gujarat

Title of your Innovation *

Nature of Work/Project*

Domain /Sector of your Work/Innovation

if Other*

Type of University*

Institute/College Name*

Category of application*

Student Young Innovator award

TeamLeader's name*

Gender*

Male Female

Email ID*

Mobile Number*

Mentor's name

Mentor's Gender

Male Female

Mentor's Email ID

Mentor's Mob Number

Name of other team members

Present Study Status*

Nature of study when you finished the project/innovation*

Have you filed IP/Patent for your solution/offering*

Yes No

Nature of your Innovation*

What exact problem solution you are trying to solve through your innovation(100-1500 Character) *

What is your Technical Approch to Solve the Problem (100-1500 Character)*

What is Origional/Unique/Novel in your Proposed Solution/Innovation(100-1000 Character)*

Summary of the progress while developing your Project/Innovation(100-1500 Character)*

Stage of your Innovation*

Any Significant Achivement Worth Mentioning/Awards/Appreciation/Others

Have you received any support/fund/grant by now,mention(if any)

what are user feedbacks for your innovation from market/end user(100-1000 Character) *

Attach ppt Describing your innovation withphoto (PPT Only)*

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I/We hereby declare that the above furnished information & facts stated are true to the best of my/our knowledge and that, if same is found faulty, I/We will be held responsible for any deviation or action taken from the Authority at a later stage.

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