Application Form 2

Application section 1: Project Background check
Application section 2: Academia Personal Information
Application section 3: Industrial Partner Information
Application section 4: Project Detailed Information
Application section 5: Video & Image of Functional Prototype
View Application (This link is only for Application Viewing, please don't make any changes cause it might not be saved)

Application Type

Fund Phase

PERSONAL INFORMATION

University Name

Specify University Name *

Faculty Name

Which faculty do you represent? *

Faculty Name *

Faculty Dean Contact Info

Dean of Faculty Email Address *

Dean of Faculty Full Name *

Faculty Phone Number *

Academic Supervisors Contact Info

Lead Supervisor Email Address *

Lead Supervisor Full Name *

Lead Supervisor Phone Number *

Pledge From The Supervisor

For a template, please download this file and fill it. Upon application approval, please provide a signed copy to IRALEB offices.

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Title

Alternative Text

Leave empty if the image is purely decorative.

Caption

Description

Second Supervisor

Second Supervisor Email Address

Second Supervisor Full Name

Second Supervisor Phone Number

Third Supervisor

Third Supervisor Email Address

Third Supervisor Full Name

Third Supervisor Phone Number

Application Type

Fund Phase

Participating Students Contact Info

Lead Student Email Address *

Lead Student Full Name *

Lead Student Phone Number *

Lead Student Major of Study *

Lead Student Major of Study Other *

Lead Student Year of Study *

Second Student Contact Info

Second Student Email Address

Second Student Full Name

Second Student Year of Study

Second Student Phone Number

Second Student Major of Study

Second Student Major of Study Other

Third Student Contact Info

Third Student Email Address

Third Student Full Name

Third Student Year of Study

Third Student Phone Number

Third Student Major of Study

Third Student Major of Study Other

Fourth Student Contact Info

Fourth Student Email Address

Fourth Student Full Name

Fourth Student Year of Study

Fourth Student Phone Number

Fourth Student Major of Study

Fourth Student Major of Study Other

Fifth Student Contact Info

Fifth Student Email Address

Fifth Student Full Name

Fifth Student Year of Study

Fifth Student Phone Number

Fifth Student Major of Study

Fifth Student Major of Study Other

If you are the only student in this project, you are Lead student