TIEP - Registration

Registration

TIEP - 2012

Application Deadline: June 30, 2012 11:59 AM, AST

1. Applicant Information

Prefix

First (or Given) Name *

Middle Name or Initial

Last (or Family) Name *

Date of Birth

(mm/dd/yyyy)

Gender

Nationality *

Job Title

Company / Organization

Address Line 1

Address Line 2

Address Line 3

City *

Country *

Zip/Postal Code

Mobile Number
(Country Code, Area or City Code, Telephone Number, Extension) *

Business Number
(Country Code, Area or City Code, Telephone Number, Extension)

E-mail *

Company/Organization Website

Education

Institution	Location	Degree	Major	Year of Graduation

Please indicate how you first learned about the Technology Innovation and Entrepreneurship Program

If you were referred to this program by an alum or current student, please fill out this section:

I was Referred to the TIEP by:

Referral Code:

Resume *

Please attach (Word or PDF) a current CV that includes publications, patents, awards, professional presentations and references

2. Describe your entrepreneurial ambitions *

Include what you hope to learn from the program that will help you realize these ambitions.

3. Apply an idea for a new business to the program (Optional)

If you have an idea for a new venture, and you would like to take your idea with you into the class for further development in this program, please answer the following questions

1. Briefly describe the technology/idea, including the level of increased performance over competing technologies/ideas.

2. Briefly describe the market need for your technology/idea, including the key customer benefits and market segment(s) you are targeting.

3. Briefly describe the current (or potential) intellectual property position in your technology/idea, including any patent applications, licenses, copyrightable software, etc. as applicable.

Your idea will be reviewed by the selection committee, independently from your personal application.

Feel free to attach an additional document that describes your idea in more detail:

4. Fees

The total fees for the Technology Innovation and Entrepreneurship Program are US$12,000, or QAR 43,800.

The fees are payable in 4 installments of US$ 3,000 throughout the course period.

The costs for reading materials are included in this fee.

TIEP will order the required reference texts for the students, and distribute them in class. The costs, estimated at US$220/QAR 800 for the whole program.

Once you are accepted in the program, you can apply for a scholarship from Qatar Science & Technology Park.
If you receive the scholarship, you will be entitled to a waiver of the tuition fee.

Scholarships numbers are limited and will be subject to a separate scholarship process subsequent to your acceptance on the program.

Commitment toward the projects and course deliverables are the main conditions for maintaining a scholarship.
QSTP maintains the right to withdraw a scholarship if a participant does not meet expectations.

If you are paying the fee from your own resources

If you intend to start a technology company in Qatar please indicate if you wish to be considered for a scholarship from Qatar Science & Technology Park. Please note that scholarships numbers are limited and will be subject to a separate scholarship process conducted by QSTP subsequent to your acceptance on the program.

If your employer is sponsoring your fees. Please give us the contact details of the appropriate contact person at your company.

Contact Name *

Contact Function

Contact Number *

Contact Email *

Sponsorship Commitment Form

Download

5. Payment

After applicants have been notified of their acceptance, they will be sent an invoice prepared by Qatar Foundation for the US$3,000 registration fee, which will have to be paid before the cut-off date to reserve a seat on the program.

The remaining course fees can be paid in installments.

Terms of Cancellation

The deadline to cancel your registration and receive a full refund is one week prior to the first class meeting.