[xyz-ips snippet=”ControlAccesstoSingleViewApp”] Title of the Project * Application Type Fund Phase Applicant Data Are you applying for? * Undergraduate & Master Doctorate Are you applying for? * – Select –Graduating ProjectDoctorate ProjectProfessional ProjectInternational Lebanese Innovators Email address * Applicant Full Name * Applicant Phone Number * Which best describes the applicant? * – Select –Lead supervisorAcademic SupervisorLead studentStudent Are you eligible to apply for the industrial Fund as per the regulations published on our website? * Yes No Sorry you are not eligible to apply for this Fund Are you eligible to apply for the IRALEB exhibition as per the regulations published on our website? * Yes No Will you be able to demonstrate a functional prototype of this project at the IRALEB Forum, within nine months * (Doctorate projects may be eligible to present their prototype at the next annual forum) Yes No Sorry you are not eligible to apply for this Fund Previous LIRA Participations Have you previously received funding support from LIRA for a different project? Yes No Kindly list the Project Title(s) and Year(s) for all previous projects that you have been admitted to, while stating which ones you weren’t able to display at the forum (if any), and why? * Visual Text Additional Information Have you received or expecting any form of funding for this project from any source(s) other than Iraleb? * Yes No Project Background Have you done an extensive research about similar existing projects? * Yes No Does your project commercially exist in other forms? * Yes No Does your project offer higher added value relative to existing technologies, in terms of functionality, design, manufacturability, sustainability or cost, while respecting applicable certification codes? * Yes No Have you signed a technology transfer policy with your industrial partner? * Yes No Do you wish to receive support services for securing intellectual property rights? * Yes No You are not eligible to apply for this Fund, please read thoroughly our regulations Application Type Fund Phase PERSONAL INFORMATION University Name Which university are you applying from? * American University of Beirut (AUB) Specify University Name * Faculty Name Which faculty do you represent? * – Select –Faculty of EngineeringFaculty of SciencesFaculty of PharmacyFaculty of Food IndustryFaculty of AgricultureOthers, Please specify 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. File name: File size: No file selected Add File 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 * – Select –Civil EngineeringElectrical EngineeringMechanical EngineeringBiomedical EngineeringChemical and/or Petrochemical EngineeringElectro-mechanical EngineeringComputer and Communication EngineeringComputer EngineeringIndustrial EngineeringBiologyBioChemistryFood SciencePharmacologyOther, please specify Lead Student Major of Study Other * Lead Student Year of Study * – Select –Final Year on a Bachelor of EngineeringAny year on a Master of EngineeringAny year on a Master of ScienceAny year on a Doctorate Second Student Contact Info Second Student Email Address Second Student Full Name Second Student Year of Study – Select –Final Year on a Bachelor of EngineeringAny year on a Master of EngineeringAny year on a Master of ScienceAny year on a Doctorate Second Student Phone Number Second Student Major of Study – Select –Civil EngineeringElectrical EngineeringMechanical EngineeringBiomedical EngineeringChemical and/or Petrochemical EngineeringElectro-mechanical EngineeringComputer and Communication EngineeringComputer EngineeringIndustrial EngineeringBiologyBioChemistryFood SciencePharmacologyOther, please specify Second Student Major of Study Other Third Student Contact Info Third Student Email Address Third Student Full Name Third Student Year of Study – Select –Final Year on a Bachelor of EngineeringAny year on a Master of EngineeringAny year on a Master of ScienceAny year on a Doctorate Third Student Phone Number Third Student Major of Study – Select –Civil EngineeringElectrical EngineeringMechanical EngineeringBiomedical EngineeringChemical and/or Petrochemical EngineeringElectro-mechanical EngineeringComputer and Communication EngineeringComputer EngineeringIndustrial EngineeringBiologyBioChemistryFood SciencePharmacologyOther, please specify Third Student Major of Study Other Fourth Student Contact Info Fourth Student Email Address Fourth Student Full Name Fourth Student Year of Study – Select –Final Year on a Bachelor of EngineeringAny year on a Master of EngineeringAny year on a Master of ScienceAny year on a Doctorate Fourth Student Phone Number Fourth Student Major of Study – Select –Civil EngineeringElectrical EngineeringMechanical EngineeringBiomedical EngineeringChemical and/or Petrochemical EngineeringElectro-mechanical EngineeringComputer and Communication EngineeringComputer EngineeringIndustrial EngineeringBiologyBioChemistryFood SciencePharmacologyOther, please specify Fourth Student Major of Study Other Fifth Student Contact Info Fifth Student Email Address Fifth Student Full Name Fifth Student Year of Study – Select –Final Year on a Bachelor of EngineeringAny year on a Master of EngineeringAny year on a Master of ScienceAny year on a Doctorate Fifth Student Phone Number Fifth Student Major of Study – Select –Civil EngineeringElectrical EngineeringMechanical EngineeringBiomedical EngineeringChemical and/or Petrochemical EngineeringElectro-mechanical EngineeringComputer and Communication EngineeringComputer EngineeringIndustrial EngineeringBiologyBioChemistryFood SciencePharmacologyOther, please specify Fifth Student Major of Study Other If you are the only student in this project, you are Lead student Application Type Fund Phase Industrial Partner Is your project being developed directly with an industrial partner? * Yes No Sorry you are not eligible to apply for this Fund. Please check our website to find an industrial sponsor 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) File name: File size: No file selected Add File 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. File name: File size: No file selected Add File Application Type Fund Phase Project Detailed Information Project Title * Primary Field * – Select –Mechanical & MechatronicsElectrical & Electronics Engineering & SciencesCivil EngineeringInformation & Communication TechnologyChemical & Pharmaceutical IndustriesAgro-Food IndustryPacking & PackagingMaterials & NanotechnologyOther Industry Related Applications Other Primary Field * Secondary Field * – Select –Mechanical & MechatronicsElectrical & Electronics Engineering & SciencesCivil EngineeringInformation & Communication TechnologyChemical & Pharmaceutical IndustriesAgro-Food IndustryPacking & PackagingMaterials & NanotechnologyOther Industry Related Applications Other Secondary Field * Brief Description of the Project (English) * Visual Text Brief Description of the Project (Arabic) * Visual Text Uniqueness and Innovation * Visual Text Detailed Design * Visual Text Proof of Viable Industrial Application of the Project * Visual Text Expected Deliverables * Visual Text Work Plan * Visual Text Detailed Project Budget * Visual Text Detailed Project Budget file File name: File size: No file selected Add File Application Type Fund Phase Video & Image of Functional Prototype Photo of Team Members No image selected Add Image Virtual Render of Prototype * No image selected Add Image Photo(s) of Built Prototype No image selected Add Image Project 1 or 2 minutes video presentation: kindly upload short video of the functional prototype File name: File size: No file selected Add File If you already have a real image of the finalized functional prototype, kindly upload it here No image selected Add Image ID of Lead Supervisor (recto) * No image selected Add Image ID of Lead Supervisor (verso) * No image selected Add Image Provide a scanned signed copy of the pledge signed by the Lead supervisor engaging to implement the prototype and exhibit it at the Forum * No image selected Add Image First Acknowledgement * You acknowledge that, in case your application is retained, the latest date for sending us a short video and final real image of your functional prototype is July 2022, and that failing to provide it can result in disqualification (with the exception of Doctorate applicants) Second Acknowledgement * If your application was successful, you certify that you will be able to showcase a functional prototype of this project at the LIRA 16 Forum in early November Third Acknowledgement * By submitting the application, you certified that all information presented is true, to the best of your knowledge, and you acknowledged that any false information or any form of plagiarism will lead to immediate disqualification from participating in any IRALEB related competitions or events.
