The information that you provide in this form is used by MedTech Actuator to assess your application. This information, including personal information, will be disclosed to the Application Review Board made up of MedTech Actuator members and its partners, and non-confidential information may be made public through MedTech Actuator social media and websites.
I, certify that:
• The statements in this application are true to the best of my knowledge and any supporting material is my own work.
• I accept that MedTech Actuator reserves the right to use whatever assessment processes and selection criteria they deem necessary to evaluate this application for the Origin program.
• If my application is successful, I consent to my ‘Project sentence’ and ‘Non-confidential summary’ to be used by MedTech Actuator for announcements via their respective social media platforms and websites.
• I am committed to participating fully in the program sessions and agree to be available on the following dates:
Origin Workshops - 7 Oct
Rapid Fire Round - 21 Oct
Sprint Intensive - 15 Nov - 17 Nov
Pitch competition - 17 Nov
MedTech Actuator Showcase - 9 Dec
By signing (typing your legal name) in the space below, you are certifying that all information is correct and that you are the person completing this application. When you press the submit button, you will receive an email confirmation that your application was received. Please print for your records and retain as verification of your application.