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i Application form

Every potential fellow fills out an application form. Each question is designed to help everyone understand the essence of what, why and how a change will manifest.

Prospective applicants often ask us to narrow down the parameters for applications and be more specific about what we’re looking for. We are not planning on doing that, as we want to be surprised and intrigued by applicants, no matter how unconventional the idea may be.

Deliberately, the form uses clean, simple questions that carve a narrative and act as a basis for conversation and partnership.

Personal information

First name  
Last name  
Email address  
Date of birth  
Nationality  
Gender Male/Female/Non-binary/Rather not say

Questions

  1. Tell us about the world as you see it.
    A description of the status quo and context in which you will be working

  2. What change do you want to make in the world?
    A description of what you want to change about the status quo, in the world, your personal vision for this area

  1. What do you believe has prevented this change to date?
    Describe the innovations or questions you would like to explore during the fellowship year

  2. What are you going to do to get there?
    A description of what you actually plan to do during the year

  3. What challenges or uncertainties do you expect to face?

  4. What part does openness play in your idea?

  5. Does your idea/project have a name? □ Yes □ No

  6. Have you started implementing the idea? □ Yes □ No

  7. How have you funded your initiative in the past?

    □ Self funded
    □ Family and friends
    □ Not funded yet
    □ Angel investor
    □ Venture capital
    □ Other

  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?

    □ For profit
    □ Not for profit
    □ Haven’t thought about it…

  10. Where will you be based during the fellowship?
    Base country, base city

  1. Where will you implement your idea?

    □ Same as above
    □ Online
    □ Other country or city

  2. Do you have an online presence? □ Yes □ No

  3. Does the idea/project have an online presence? □ Yes □ No

  4. Upload résumé
    PDF file is preferable

  5. Link to your video
    Vimeo or YouTube preferable. Facebook or Dropbox links not accepted

  6. Video password
    If private

  7. I acknowledge that:

    □ This video is purpose made for this application.
    □ This video link points to a video available on a video hosting service like Vimeo or YouTube.

  8. Have you applied for a Shuttleworth Foundation Fellowship in a previous round? □ Yes □ No

  9. How did you hear about the Shuttleworth Foundation Fellowship Program?

    □ Friend
    □ Current/Past fellow
    □ On the web
    □ In the mainstream media
    □ At a conference
    □ Other