Application form – “Competition on Innovations in Water Sector: 2017”

01 / Application Type: -Area of interest and title
02 / Applicant’s Details
[For individual applicants his/her details should be given.]
[For group applications a main * or contact* person’s details should be given.]
Name*(name with initials in capital Letters): Prof./Dr./Rev./Mr. / Mrs. / Miss (Strike off non relevant part)
Applicants Post
Office Contact Number
Office fax Number
Mobile Contact Number
E Mail address
For group applications:Team Leader* / Contact Person* (Strike off non relevant part)
* in groups applications, if there is a Team Leader and the role of each member to be described with details of the responsible person with contact details.
03 / Names of Other Members in Group Applications
The names of the other members.
The name with initials should be written in capital letters.
1.
2.
3.
4.
5.
04 / Details of place of work Place of work and Address:
05 / Title of Innovation/outline
[This should specify a name for the innovation (using a maximum of 10-15 words)
06 / Description of innovation
A description of your innovation in no more than 500 words should be attached as Annex 11.the description should explain,
  1. How the proposal could be qualified as an innovation
  2. How it could be used to address a particular issue or improve a current practice
  3. The objectives or benefits that could be derived from implementation
  4. Relevancy to water sector and components
  5. The level of implementation
  6. What are the impacts or benefits that would be possible through implementation of the innovation in the Water sector?
  7. Snowballing effect of the proposed innovation
  8. Any other relevant details

07 / Applicant’s Declaration
I certify that the details furnished above by myself are true and correct and that this innovation has not been submitted for previous Innovation competitions.
Signature of Applicant: Date:

Note

  1. Attach Annex 1 – description of your innovation
  2. Attach other Annexes if necessary (comments of immediate Supervisor, Head of the Institution or further details/ information of the innovation)
  3. The duly completed application forms should be sent in registered postto reach the below address on or before 12th October 2017. Top left hand corner of the envelop should be marked as “INNOWATER 2017”.

Secretary- Water Forum

Institution of Engineers Sri Lanka

120/15

Wijerama Mawatha

Colombo 7