Application Form 3

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

Industrial Partner

Is your project being developed directly with an industrial partner? *

Yes No

Does your industrial partner hold a valid industrial license? *

Yes No

Kindly add a copy of the industrial license (a copy of the MOF registration can be provided only for hospitals and IT companies)

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Industrial Partner Contact Info

What is the corporate name of your industrial partner establishment? *

Industrial Partner Email Address *

Name of contact person at your industrial partner establishment? *

Industrial Partner Phone Number *

Letter of support from the Industrial Partner

For a template, please download this file if you are applying for "Undergraduate & Master" or this file if you are applying for "Doctorate" and fill it. Upon application approval, please provide a signed copy to IRALEB offices.

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Signed Scanned Copy of the Application

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Application Type

Fund Phase

Video & Image of Functional Prototype

Photo of Team Members

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Virtual Render of Prototype *

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Photo(s) of Built Prototype

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Project 1 or 2 minutes video presentation: kindly upload short video of the functional prototype

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If you already have a real image of the finalized functional prototype, kindly upload it here

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ID of Lead Supervisor (recto) *

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ID of Lead Supervisor (verso) *

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Provide a scanned signed copy of the pledge signed by the Lead supervisor engaging to implement the prototype and exhibit it at the Forum *

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