Innovation Incubator Program Application

Introductory Information

* What is the name and URL of your innovative project, product or service? (limit to 50 characters)

* Your primary interest in participating in the Innovation Incubator Program at the Ed Tech Industry Summit is to seek support and/or partnership opportunities for: (Check all that apply)

    Additional funding / investment
    Commercialization, licensing or distribution by education partner
    Concept validation / market input
    Early pilot studies / field testing in education institutions
    Efficacy studies / research
    Other, please specify:

Ed Tech Industry Summit Participation

For those selected to participate in the Ed Tech Industry Summit Innovation Incubator Program: participation includes online presentations to educators & administrators for the Educators' Choice Award, attending the Summit, a presentation to Summit attendees during the Business Profiles session, demonstration of the innovation at the Incubator Showcase (table top exhibit is included) and Networking Reception, and the opportunity to meet with potential investors/business partners during the One-to-One Business Connections meetings. Each innovator selected for participation will receive three (3) discounted registration to attend Summit.

Note: Following Sunday's presentations and Showcase, the top five (5) innovators will be selected by Summit attendees as finalists to present again on Monday, May 6. Following these finalist presentations, Summit attendees will select the Most Innovative and Most Likely to Succeed innovators (one winner and one runner-up for each recognition).

Will you need any financial support to attend the 2013 Ed Tech Industry Summit?
    Yes
    No

About Your Innovation

* How would you classify your innovation's primary educational application? Check a maximum of two.
    Assessment
    Data Management/Learning
    Digital Education Resource
    eTextbook
    Game / Simulation (including Platforms and Tools)
    Global Education
    Mobile Learning (Tablet / Smartphone)
    Online Learning
    Personalized Learning
    Social Learning
    Professional Learning
    Other / Emerging Technology, please specify:

* Who is the end user for your innovation? (Check all that apply)
    Administrator
    Faculty
    Parent
    Student
    Other, please specify:

* What markets will your innovation serve? (Check all that apply)
    Adult education
    Elementary
    ESL/ELL program
    Higher education/postsecondary
    Home school
    Middle school/junior high
    Pre-K
    Professional Learning
    Senior high
    Special needs
    Vocational
    Other, please specify:

* What funding has supported the development of your Innovation? (Check all that apply)
    Academic/non-profit institution
    Angel investor
    Venture capital firm
    Corporate/for-profit entity
    Education/private foundation
    Federal agency
    Self/friends and family
    State agency
    Strategic investors
    Other, please specify:

* Describe your organization's innovative products/services (limit to 500 characters)

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Please provide additional details for logging in or accessing your innovation (limit to 500 characters)

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Please provide any additional information that you would like us to take into consideration (limit to 500 characters)

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In order to select participants for the Innovation Incubator Program, this information will be shared with the following SIIA education division boards and committees: Ed Tech Industry Summit Steering Committee, Membership Committee, Postsecondary Sector Board, Tech Dev Committee, and Education Division Board of Directors, as well as educators with a significant interest in innovation and technology. If you are selected to participate in the Innovation Incubator Program, some of this information may also be provided to Ed Tech Industry Summit conference attendees.