Name*
Date of Birth*
Date of Birth
Gender*
Gender
Multiple Nationalities?*
Multiple Nationalities?
(A description of the status quo and context in which you will be working)
(A description of what you want to change about the status quo, in the world, your personal vision for this area)
(Describe the innovations or questions you would like to explore during the fellowship year)
(A description of what you actually plan to do during the year)
5) Does your idea/project have a name?*
6) Have you started implementation of the idea?*
7) How have you funded your initiative in the past? Please provide details of your selection in the space below.*
8) Who are your current or potential key partners?
9) Do you intend to implement the idea as a for profit or not for profit initiative in the future?*
10) Where will you be based during the fellowship?
11) Where will you implement your idea?*
12) Do you have an online presence?*
13) Does the idea/project have an online presence?*
14) How did you hear about the Shuttleworth Foundation Fellowship Programme?*
15) Have you applied for a Shuttleworth Foundation Fellowship in a previous round?*
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