Cardio Stars Action application form

Your First name*

Your Last name*

Email address*

Academic Institution*

Job title*

If you are applying as part of a team, please provide the full names of all additional team members (note - only one application per team is required)

Team name (if applicable)

Experience*:
Briefly describe your attributes, skills and any relevant experience you may have. Please also fill in for any additional team members.

What domain is your research/idea/startup in*?

Idea description*:
Please give a brief description of your research area or idea (Max 100 Words)

What is the unmet need/problem you are trying to address*?
Identify the scientific and/or market need that you are proposing a solution for. (Max 200 words)

What is the potential impact of your research/idea?*:
A brief description on the potential impact of your idea on patients, healthcare providers and society. (Max 100 Words)

What is unique about your research/idea?*:
What makes your idea different? What makes you different from what is already out there? What is your USP? (Max 100 Words)

Intellectual Property*:
Has any action been taken to protect IP? If so, please provide further details, including licensing agreements with academic institutions. (Max 100 words)

Are you funded by the British Heart Foundation?*:

I confirm I am able to attend the CardioStars Action bootcamp on Friday 18 October 2024

Will anyone from your team be attending the bootcamp, in addition to you? If so, please provide their full name and email address.

Please add dietary requirements and allergies for the bootcamp

I agree to the Panacea Stars Terms & Conditions