ENTRY FORM

Welcome to the Australian Technologies Competition for 2022 - Australia's national Competition, growth and partnerships program. We're looking to showcase and accelerate homegrown tech-based companies with the greatest global potential. This Competition is open to all Australian-registered businesses with tech-based solutions.

Before you get started on your Entry Form, please ensure to check your eligbility using our tick box below.

All entrants will recieve a record of their submission via email upon completion.

Entries close 11.59pm AEST on 4 July 2022.

Have a question? Please contact: atc@investible.com

Are you eligible to enter? Please ensure you can tick each of the following boxes before proceeding: * 🛈

You are an Australian-registered business

You have evidence of customer traction

You have less than 100 employees

You own or have majority ownership of your Intellectual Property

Your tech-based solution is relevant to at least one of our 12 award categories

Privacy

We respect your privacy and that of your company. Please note that information provided in this entry form will be used solely by our Judges to assess your application. All personal contact information and details of your company revenue are kept strictly confidential. Should you be selected as a semi finalist, your logo and company description will be used in promotional material.

1. Award Category

Nominate your technology/solution in a maximum of TWO Award Categories? * 🛈

2. About your Company

Company Name *

ABN: *

Company website: *

Where is your company based? *

Have you ever used the support services of Investment NSW such as their Going Global Export Program?

YES

NO

Not sure

Have you entered the Australian Technologies Competition in the past five (5) years? *

YES

NO

Not sure

3. Who is submitting this form?

If you are the Founder/CEO, you can skip this question and provide your details in the next section

First Name

Last Name

Job Role

Email

4. About your Founder/CEO

Founder/CEO First Name: *

Founder/CEO Last Name: *

Founder/CEO email: *

Founder/CEO mobile Number: *

Gender: *

Age group: *

Upload a head shot of your Founder/CEO 🛈

5. Tell us about your company's solution / technology

Describe your technology or solution in 1 - 2 lines *

0/30 words

Now describe your technology/solution in more detail, keeping it simple and jargon free: * 🛈

0/100 words

What is the customer problem you are trying to solve? * 🛈

0/100 words

Who are your customers? You can provide examples rather than explicitly stating names * 🛈

0/50 words

How is your technology/solution unique and why is it better than alternatives? * 🛈

0/100 words

How does your company make money? (Summarise your business model) *

0/100 words

6. Assessing the size and scale of your business

How many full time employees do you have? *

How many full time female employees do you have? *

In what year was your company established? *

How much capital have you invested to date? *

Amount of external funding received to date: *

What was your revenue (AUD) for the 2020-2021 Financial Year *

7. Upload Media

Upload your company logo (JPEG or PNG file) * 🛈

Upload a single image to illustrate your technology or it's application 🛈

If you have a video URL that introduces your technology in under two minutes, please supply the URL

8. Now for a few easy survey questions

How did you hear about the Australian Technologies Competition? *

If you were referred by an individual or organisation, please state their name

Have you ever used the Federal Government's R&D Tax Incentive? *

YES

NO

Not sure

Have you ever participated in the Federal Government's Entrepreneur Programme? *

YES

NO

Not sure

Have you ever received a commercialisation grant? If so, state the amount and when you received it *

9. Final Checklist

Please tick each of the following before submitting your application. *

I confirm that the company is an Australian-registered business

I understand that the Competition is seeking homegrown scaleups with the greatest global potential

My company's technology/solution aligns with at least one of the 12 award categories

My company has majority ownership of the technology's intellectual property

I understand what is expected of me in completing the full cycle of the Competition

I have answered all required questions and completed answers to the best of my knowledge