Registration Form

Personal Information

Title
 Mr. Ms.

First Name

Last Name

Email Address

Country of Residency

First Nationality

Second Nationality (optional)

Phone Number (optional)

Last Academic Degree

University

University Position

Company

Company Position

Short Biography (approximately 100 words)

Submit Your CV (Resume') file (up to 3 MB) here. (pdf is preferred)

LinkedIn Profile Link

Website or other Online Profiles (optional)

How many years of academic work experience do you have?
 None Less than 2 years 2-5 years 5-10 years 10-20 years More than 20 years

How many years of industrial work experience do you have?
 None Less than 2 years 2-5 years 5-10 years 10-20 years More than 20 years


Proposal Information

Field:
 Nanotechnologies Biotechnologies Information and Communication Technologies Cognitive Sciences

Title of Proposal

Abstract (maximum of 250 words)

Submit your Proposal file (up to 3 MB) here (pdf format is preferred)

Submit other file (up to 3 MB) regarding your proposal (optional)

What role(s) would you like to play in the execution of this proposal?
 Researcher Consultant Co-founder / Director / Manager I do not want to play any roles.

How do you want to be involved in the execution of this proposal?
 Only remotely from abroad Remotely and travel to Iran as needed Move to Iran I do not want to spend time on execution

How would you like to fund the execution of this proposal?
 No personal funding or involvement, just offering the idea No personal funding but will spend time during execution I will partially fund it I will fully fund it

What is the estimated duration for the execution of this proposal?
 Less than 6 months 6-24 months 2 - 3 years 3 - 5 years More than 5 years Ongoing

What is the estimated budget for the execution of this proposal?
 Less than $50,000 $50,000 - $200,000 $200,000 - $1,000,000 $1,000,000 - $5,000,000 More than $5,000,000

Why is it important to execute this proposal in Iran?

Why are you a good fit to execute this proposal in Iran?

What factors can increase the success rate of execution?

Do you recommend any individual, team, and/or organization who may help with the execution of this proposal?

What factors can increase your desire to engage in execution of this proposal?


Final Questions

Should your proposal be selected, are you interested to meet with Dr. Satari during his visit to New York City?
 Yes No

If you have any comments please write it here.

I certify that the above information is correct and accurate and that I am eager to work with ISTI to add value for Iran.