Sustainable Tech Showcase Application

First Name:

Last Name:

E-mail address:

Nationality:

Org/ Biz Affiliation:

Name of your innovation::

Primary Impact/Application of Technology::

Water
Waste
Transportation
Energy
Information
Health
Construction
Agriculture

Category (Submitting Party):

Innovator/
Investor
Policy

Sub-category (Environment Applied):

What level of impact can this innovation make towards the sustainability of our planet?:

Was this innovation developed over months or years – “evolutionary” or a sudden breakthrough, “revolutionary”?:

Revolutionary
Evolutionary

Is your work published, patented or secure in any way?:

Yes
No
No

What do you hope to achieve through the presentation of your innovation at The Global Summit? (4 sentences max):

What will you bring to demonstrate your innovation at Expo?:

Info
Scaled-down
Full
Other

Please describe any special space or technical requirements you might need if accepted (not in basic package or sponsor booth):

What stage of development /position do you see your innovation is at on the below flow chart?:

R&D/To
New
Marketable
Profitable
Not

Please submit Link to a video on Youtube. *Note: Needed to participate in online Global Citizens Choice Awards for most innovative, effective and appropriate in each impact area.:

In 300 words or less, describe your technology’s purpose and unique impact.:

Either as innovator or as a representative of the inventor that the technology submitted is original and does not infringe on the copyrights of any party.:

Yes

Select your interests:

Workshop Presenter / Program Partnership:

Community Outreach & Virtual Participation:

Partners In Empowerment (PIE) Knowledge Base: