Incubation Request Form — Vignana Jyothi Innovation Hub

Step 1 of 5

Personal Information

Name of the Applicant(s) *

Highest Academic Qualification(s)

Address

Mobile No. *

Alt. Mobile No.

E-mail ID *

Alt. E-mail ID

Preferred Mode of Communication

CallText / WhatsAppE-mailAny

Step 3 of 5

Incubation Information

Stage of Development / Incubation

Proof of TechnologyProof of ConceptPrototype / SimulationMinimum Viable Product

Technology Readiness Level (1–9)

Team Size (incl. self) & Gender Diversity

External Partners, if any

Intern(s) Requirement, if any

No. of People Working at VJ Hub

Co-incubation, if any (Specify Incubator)

Expected Duration for Incubation Space

Step 5 of 5

Brief & Undertaking

Brief About Startup *

Additional Notes / Comments / Requests

Undertaking

I/We have applied for my/our startup's incubation at Vignana Jyothi Foundation for Entrepreneurial Excellence ("VJ Hub"). Subject to the approval of my/our application for incubation, I/we agree that I/we shall abide by the applicable law of the land, organisation policies, and rules and regulations. I/we understand that it is my/our team's responsibility to be aware of any changes to the policies, to keep myself/ourselves updated, and to abide by them as necessary. I/we shall bring any issues of concern to the notice of the Manager, VJ Hub, or a suitable Point of Contact.

I/We accept the undertaking above.

VJHub-Form-001/2022 Rev.00