Full Name of the Applicant (Name-Middlename-Surname) Email Mobile No (WhatsApp) Complete Address for Communication State Select StateAndhra PradeshArunachal PradeshAssamBiharGoaGujaratHaryanaHimachal PradeshJharkhandKarnatakaKeralaMadhya PradeshMaharashtraManipurMeghalayaMizoramNagalandOdishaPunjabRajasthanSikkimTamil NaduTelanganaTripuraUttar PradeshUttarakhandWest BengalAndaman and Nicobar IslandsChandigarhDadra and Nagar Haveli and Daman and DiuLakshadweepDelhiPuducherryLadakhJammu and Kashmir City Gender Select GenderMaleFemaleOther Educational Qualification Select Educational QualificationSchool of Secondary EducationBoard of Intermediate EducationGraduationPost-GraduationPhDOther Profession Select ProfessionStudentWorking ProfessionalEntrepreneurFarmerOther One-liner on what your Idea/Prototype/Product is about (Please describe in 200 characters or less)

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At what stage are you in developing your product/offering? Concept – Idea stageProof of Concept – Some experiments donePrototype – Several proofs of concept demonstratedPilot – Minimum viable product (MVP)Production – Commercially readyAlready in the Market What is the customer's problem that you are solving? Share a real-life example How do you solve the aforementioned problem? Details of your core team members (Name, designation, qualification, relevant experience in years) What is the social impact of your business model/idea/startup? How is your solution different from existing market solutions? What makes customers choose you and stay with you? Who is your target customer? Revenue Model - How will you make money? Market Size - Describe in 200 characters or less Achievements so far in terms of prototype development, customers, revenues, etc. Funding received till date (if applicable) Competitor analysis - Who else is solving this problem, and how are you different?

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Are you ready to spend 1 month at the incubation center? YesNoMaybe What are your expectations from AIC-ADT? Access to MarketAccess to Mentors (business and technology)Access to Infrastructure (Co-working Space, Makers Lab, FABLAB)Access to Field TrialsProduct Refinement/Testing and Trials/Marketing Launch Why do you want to join our incubation program? Additional information (max 100 words) Where did you hear about this program? FacebookLinkedInInstagramTwitterNewspaper Declaration: I hereby declare that the details furnished above are true and correct. Agree

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