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Incubator Support - Expert in Residence application form
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Receipt

Incubator Support - Expert in Residence application form
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Instructions

Incubator Support - Expert in Residence application form
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About the Incubator Support Initiative
The $23 million Incubator Support initiative supports the Australian Government’s commitment to: assist Australian start-ups to develop the capabilities required to achieve commercial success in international markets and realise their economic potential faster than they otherwise would develop Australia’s innovation ecosystem including in regional areas. The initiative provides grant funding through two components to deliver Incubator Support projects, both of which require a funding contribution from applicants. These are: New and Existing Incubators Expert in Residence In addition to these granting components, regional incubator facilitators are available to assist potential applicants, particularly in regional areas, to engage with the initiative. The initiative will also assist successful applicants to access public data, and will promote start-ups through case studies on the data.gov.au portal. The objective of the Expert in Residence component is to: increase the capabilities of incubators and improve the chance of commercial success for start-ups in international markets by organising and providing access to top quality research, managerial and technical talent through incoming and outgoing secondments of national or international experts. The initiative’s intended outcomes are to: support new Australian incubators targeting innovative start-ups to assist them to trade internationally expand the scale and operations of existing Australian incubators to increase innovative start-ups’ chances of success in international markets develop new innovative Australian start-ups with a focus on international markets create opportunities for Australian start-ups to develop sustainable businesses through access to open public data.
Completing this form
You should read the Program Guidelines before filling out this application.
Your privacy
The Commonwealth’s use and disclosure of your personal information (provided in this application or otherwise) is set out in the Program Guidelines. Please ensure you have read this document and understand the information contained therein. For further information regarding the Department’s obligations in accordance with the Privacy Act, please refer to the Department’s Privacy Policy: http://www.industry.gov.au/Pages/PrivacyPolicy.aspx.
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Getting help
If you require assistance completing this application form please contact us on 13 28 46 or at business.gov.au. Our website and staff can help you with forms, finding business information and services and allow you to provide feedback, comments or suggestions. You should also read and understand the program guidelines and sample grant agreement(s) before completing an application. View these documents at business.gov.au.
Requirements
This form functions best when it is completed using the most recent version of your internet browser. This form is not compatible with Internet Explorer 8 or earlier browsers. If you are using an earlier browser version, you may have difficulty in displaying the form correctly or it may not display at all.
Unsubmitted forms
You can save your unsubmitted form by clicking SAVE FOR LATER at the top of this form. This form has a Tracking Code displayed in the top right corner. Please make a note of this Tracking Code for your records. The Tracking Code is required to reopen your saved form and you will need to provide this code if you require assistance with your form. Incomplete, unsubmitted forms are retained for a maximum of 60 days before being deleted. Your active form should be saved during this 60 day timeframe otherwise it will be deleted and you will need to start a new form.
Attachments
All attachments marked as required must be attached before your application can be submitted. Files with ".pdf, .rtf, .doc, .docx, .xls, .xlsx" extension types can be uploaded. Total file size of all attachments in the application should not exceed 20MB.
Submitting your form
You can apply for the Incubator Support Initiative at any time over the life of the program. You will be provided with a receipt to confirm that your submission has been successful. Please keep this receipt for your records by using the “Download the form and receipt” link or by emailing yourself a copy of the receipt and submission. Both of these options are available in the “To keep a copy of the completed form” box on the Submission Complete page. If you have any enquiries relating to submission of your form, you will need to provide your receipt number.

Eligibility

Incubator Support - Expert in Residence application form
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Eligibility

This section will help you determine whether you are eligible to apply for the program.
Is your organisation an incubator?
We define an incubator as a business support organisation that fosters innovative start-ups, focused on international trade, through the provision of services such as seed funding, colocation, mentoring, professional services and access to networks. It can include accelerators and germinators.
Does your organisation have an Australian Business Number (ABN)?
For trustees applying on behalf of a trust, this refers to the ABN of the trust
Is your organisation an entity incorporated in Australia?
Is your organisation an incorporated trustee applying on behalf of a trust?
You must be able to provide a copy of the trust documents showing the relationship of the incorporated trustee to the trust.
Is your organisation a publicly funded research organisation?
This includes all higher education providers listed at Table A and Table B of the Higher Education Support Act 2003 (Cth)
Is your organisation an incorporated not for profit organisation?
This includes community groups with voting and/ or financial membership of at least five individuals?
Is your organisation a local government agency or body?
A local government agency or body is a local governing body as defined in the Local Government (Financial Assistance) Act 1995 (Cth).
Is your organisation a Commonwealth or state/territory government agency or body (including PFROs and government business enterprises)?
Is your organisation an Australian state/ territory government?
Are you able to provide a resume/s outlining the experience and capabilities of the expert/s?
Will your project include eligible activities and eligible expenditure?
This includes assisting Australian start-ups to develop the capabilities required to succeed in international markets and boost the effectiveness of new and existing incubators. Examples of eligible activities include but are not limited to: a.a workshop where an expert gives advice on how to develop business opportunities in international markets; and b.engaging a national or international expert to assist start-ups during an accelerator program or sharing best practices incubator knowledge.
Will your total project value be at least $10,000?
Does your project involve incoming experts providing expertise and/or outgoing experts visiting a host incubator that will benefit you?

Incoming experts only

Can you confirm the incoming experts involved in your project are not current employees of your incubator?
Can you provide a resume for each incoming expert outlining their experience and capabilities?
You will be required to provide a resume for each incoming expert with your application.

Outgoing experts only

Can you provide a letter of commitment from the host incubator your expert employee is visiting?
You will be required to provide a letter of commitment from the incubator your employee is visiting with your application.
Can you provide a satisfactory summary of your project that describes how the new knowledge will benefit your incubator and innovative start-ups in line with program objectives?
You must provide this summary later in the form.
You are not eligible to apply for the program. Please refer to the Program Guidelines.

Contact details

Incubator Support - Expert in Residence application form
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Primary contact

Person authorised to act on behalf of the applicant.
You must provide either a phone or mobile number. *
Provide the postal address of the primary contact.
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Is the applicant the primary contact’s employer?
Provide a contact for the applicant organisation.
You must provide either a phone or mobile number. *
Provide the postal address for the contact of the applicant organisation.
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Feedback

How did you hear about the program? *
Select all that apply.

Applicant information

Incubator Support - Expert in Residence application form
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General information

If you have previously completed an application for another element of the Incubator Support Initiative, please enter the tracking number for that application here.
This will mean you will not have to enter information again that you have already entered for the other application.
Are you an existing or new incubator?
Does your project involve incoming experts providing expertise and/or outgoing experts visiting a host incubator that will benefit you?

Incoming experts only

Can you confirm the incoming experts involved in your project are not current employees of your incubator?
Can you provide a resume for each incoming expert outlining their experience and capabilities?
You will be required to provide a resume for each incoming expert with your application.

Outgoing experts only

Can you provide a letter of commitment from the host incubator your expert employee is visiting?
You will be required to provide a letter of commitment from the incubator your employee is visiting with your application.
Can you provide a plan on how the new knowledge will benefit your incubator and innovative start-ups in line with program objectives?
You will be required to provide a plan with your application.
Are you an existing or new incubator?

Joint application

Joint applications are acceptable, provided you have a lead applicant who is the main driver of the project and is eligible to apply.
Is this a joint application?
The lead applicant must complete this form. If you are unsure of whether your application should be a joint application contact us on 13 28 46 or at business.gov.au.
You are required to list all the joint project partner organisations, starting with the lead applicant. If the lead applicant is a trustee of a trust, enter the trust ABN.
Please enter the ABN of all Australian partners in the joint application and click the Validate button to retrieve your registration details.

You will be required to provide a copy of the trust documents showing the relationship of the incorporated trustee to the trust.
This is the ABN registered for the trustee as an entity in its own right.
The entity name refers to the name that appears on all official documents or legal papers. The entity name may be different from the business name.
Your business may have registered one or more business names. If you operate under a business or trading name you can enter alternate name(s) here. If your business or trading name is not listed here select ‘Other’.
If you have not registered your business name but trade under another name enter it here.
Upload a copy of the trust documents showing the relationship of the incorporated trustee to the trust
File:
You must attach a letter of support from each of the other organisations involved in the proposal. * Refer to section 11.2 of the program guidelines for what is required in the letter of support.
File:
Are there international project partners?

International project partners

Please enter details of all international project partners

International project partner

Type of applicant

In this section you must indicate what type of entity you operate under. All entities must have an ABN.
Select which type of entity your organisation is: *
To be eligible the company must be incorporated in Australia under the Corporations Act 2001, have an ABN and an ACN and be non-tax-exempt.
For trustees applying on behalf of a trust, you must enter the details of the trustee acting in its capacity as a trustee on behalf of a trust.

Applicant details

These details have been populated from the first collaboration partner entered above.
You will be required to provide a copy of the trust documents showing the relationship of the incorporated trustee to the trust.
This is the ABN registered for the trustee as an entity in its own right.
The entity name refers to the name that appears on all official documents or legal papers. The entity name may be different from the business name.
Your business may have registered one or more business names. If you operate under a business or trading name you can enter alternate name(s) here. If your business or trading name is not listed here select ‘Other’.
If you have not registered your business name but trade under another name enter it here.
You must provide a copy of the trust documents showing the relationship of the incorporated trustee to the trust.
File:

Trust and trustee details

These details have been populated from the first collaboration partner entered above.
You will be required to provide a copy of the trust documents showing the relationship of the incorporated trustee to the trust.
This is the ABN registered for the trustee as an entity in its own right.
The entity name refers to the name that appears on all official documents or legal papers. The entity name may be different from the business name.
Your business may have registered one or more business names. If you operate under a business or trading name you can enter alternate name(s) here. If your business or trading name is not listed here select ‘Other’.
If you have not registered your business name but trade under another name enter it here.
You must provide a copy of the trust documents showing the relationship of the incorporated trustee to the trust.
File:
You will be required to provide a copy of the trust documents showing the relationship of the incorporated trustee to the trust.
This is the ABN registered for the trustee as an entity in its own right.
The entity name refers to the name that appears on all official documents or legal papers. The entity name may be different from the business name.
Your business may have registered one or more business names. If you operate under a business or trading name you can enter alternate name(s) here. If your business or trading name is not listed here select ‘Other’.
If you have not registered your business name but trade under another name enter it here.
You must provide a copy of the trust documents showing the relationship of the incorporated trustee to the trust.
File:

ANZSIC details

What is your organisation's main revenue earning activity under the Australian and New Zealand Standard Industrial Classification (ANZSIC)?
The Australian and New Zealand Standard Industrial Classification (ANZSIC) is a classification system used by government to group data about organisations based on their primary business activity.The ANZSIC codes and titles are available from the Australian Bureau of Statistics (ABS) website.Phone 13 28 46 if you require assistance.

Address details

Provide your organisation's street address (Australian Head Office).
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Country *
Please enter the country’s two letter code. You can find the two letter code by clicking this link to the ISO resource and selecting 'Country codes' above the search field.
Is your postal address the same as your organisation street address?
Provide your Postal Address
This widget uses Google Places. In order to use it you need to comply with the Google Place API Policy. To summarise

Your Terms of Use and Privacy Policy must be publicly available. You must explicitly state in your applications Terms of Use that by using your application, users are bound by Google’s Terms of Service. You must notify users in your Privacy Policy that you are using the Google Maps API(s) and incorporate by reference the Google Privacy Policy.
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Country *
Please enter the country’s two letter code. You can find the two letter code by clicking this link to the ISO resource and selecting 'Country codes' above the search field.

Website address

Project site address

Enter the project incubator site address. If your project involves outgoing experts working with host incubators, the 'host' incubator address should be entered under the ‘Project Details and Funding tab’/later in the form.
Will the project’s activities occur solely at the above listed head office address?
A project site address must be a street address, not a postal address.

Site Address

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Country *
Please enter the country’s two letter code. You can find the two letter code by clicking this link to the ISO resource and selecting 'Country codes' above the search field.
Is your business located in Australia?
This widget uses Google Places. In order to use it you need to comply with the Google Place API Policy. To summarise

Your Terms of Use and Privacy Policy must be publicly available. You must explicitly state in your applications Terms of Use that by using your application, users are bound by Google’s Terms of Service. You must notify users in your Privacy Policy that you are using the Google Maps API(s) and incorporate by reference the Google Privacy Policy.
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This widget uses Google Places. In order to use it you need to comply with the Google Place API Policy. To summarise

Your Terms of Use and Privacy Policy must be publicly available. You must explicitly state in your applications Terms of Use that by using your application, users are bound by Google’s Terms of Service. You must notify users in your Privacy Policy that you are using the Google Maps API(s) and incorporate by reference the Google Privacy Policy.
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Country *
Please enter the country’s two letter code. You can find the two letter code by clicking this link to the ISO resource and selecting 'Country codes' above the search field.

Latest financial year figures

Has your organisation existed for a complete financial year?  *
We collect the following data from all applicants across all grant opportunities. We use this data to better understand your organisation and to help us develop better policies and grant opportunities.All amounts in the table below must show a whole dollar value e.g. $1 million should be presented as $1,000,000. The turnover value must be that of the entity that is making the grant application (the ‘applicant’), regardless of whether the entity belongs to a consolidated group for tax purposes.These fields are mandatory and entering $0 is acceptable if applicable. If they clearly do not apply to your organisation you may select 'not applicable'.
FY
Sales revenue (turnover) *
Total revenue from the sale of goods and services, as reported in the applicant’s Business Activity Statement (BAS).
Export revenue *
Total revenue from export sales, as reported in the applicant's Business Activity Statement (BAS).
R&D expenditure *
Expenditure on Research and Development, i.e. creative work undertaken on a systematic basis in order to increase the stock of knowledge, including knowledge of man, culture and society, and the use of this stock of knowledge to devise new applications.
Taxable income *
Taxable income or loss as reported in your organisation's income company tax return form.
Employees, including working proprietors and salaried directors (headcount) *
Number of individuals who are entitled to paid leave (sick and holiday), or generate income from managing your organisation.
Independent contractors (headcount) *
Number of individuals engaged by your organisation under a commercial contract (rather than an employment contract) to provide employee-like services on site.

Ultimate holding company

Does your company have an ultimate holding company?
You will be required to provide a copy of the trust documents showing the relationship of the incorporated trustee to the trust.
This is the ABN registered for the trustee as an entity in its own right.
The entity name refers to the name that appears on all official documents or legal papers. The entity name may be different from the business name.
Your business may have registered one or more business names. If you operate under a business or trading name you can enter alternate name(s) here. If your business or trading name is not listed here select ‘Other’.
If you have not registered your business name but trade under another name enter it here.
Upload a copy of the trust documents showing the relationship of the incorporated trustee to the trust
File:

Project details and funding

Incubator Support - Expert in Residence application form
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Project title and description

If your application is successful, some project details will be published on the departmental website and Grant Connect. Published project details will include name of the applicant a project title a brief project description and its intended outcomes amount of funding awarded.
Provide a project title. *
Example project title: Mentoring and workshops for biotech startups by biotech startup expert.
Provide a brief project description for publication on our website. *
Ensure your project description focuses on your project’s key activities and outcomes. Explain what it is you are going to do and how it will benefit your business. Example project description: Singapore serial entrepreneur will provide mentoring and workshops in biotech startups over a 3 month period.

Summary of activities and outcomes

You may attach up to 3 A4 pages supporting your project.

Attachment

Attachment
File:

Details of incoming experts in residence

Provide the following details regarding the expert/s involved in your project. You must attach a resume for each expert.

Incoming expert

Resume
File:

Details of outgoing expert and Host incubator

Where you have indicated your project involves an outgoing expert visiting a host incubator complete the following. You must attach a letter of commitment for each host incubator.

Provide the following details regarding the outgoing expert involved in your project

Outgoing Expert

Host incubator

Provide details of the host incubator

Provide details of the primary contact at the host incubator

Provide street address of the host incubator

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Your Terms of Use and Privacy Policy must be publicly available. You must explicitly state in your applications Terms of Use that by using your application, users are bound by Google’s Terms of Service. You must notify users in your Privacy Policy that you are using the Google Maps API(s) and incorporate by reference the Google Privacy Policy.
Once you have complied with Google's policy you should hide this note.
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Country *
Please enter the country’s two letter code. You can find the two letter code by clicking this link to the ISO resource and selecting 'Country codes' above the search field.