Global Solutions Application Form First Name *Last Name *Email *Phone *Address *CityState / Province / RegionZip / Postal CodeAfghanistanÅland IslandsAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelauBelizeBeninBermudaBhutanBoliviaBonaire, Saint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCongo (Brazzaville)Congo (Kinshasa)Cook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyIvory CoastJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKosovoKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoNorth MacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorthern Mariana IslandsNorth KoreaNorwayOmanPakistanPalestinian TerritoryPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarReunionRomaniaRussiaRwandaSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint Martin (French part)Saint Martin (Dutch part)Saint Pierre and MiquelonSaint Vincent and the GrenadinesSan MarinoSão Tomé and PríncipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia/Sandwich IslandsSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited Kingdom (UK)United States (US)United States (US) Minor Outlying IslandsUruguayUzbekistanVanuatuVaticanVenezuelaVietnamVirgin Islands (British)Virgin Islands (US)Wallis and FutunaWestern SaharaSamoaYemenZambiaZimbabweCountryLinkedIn Profile *Face Image * Drop your Face image here or click here to upload You can upload up to 1 files. Upload CV and Academic Credentials * Drop your file here or click here to upload You can upload up to 5 files. Current Role / Job Title *Organization / Employer *Years of Professional Experience Which of the Five Pillars Are Your Strengths? *TechBusinessPolicyEthicsCommunityWhich Global Challenge Themes Interest You Most? Climate & EnvironmentWater & Food SecurityGlobal HealthSocial DevelopmentGovernanceTechnology RisksEnergy & IndustryWaste & Circular EconomyEthics & SocietyResilience & PreparednessDescribe a Project You’ve Led or Contributed To (200 – 300 words) *Why Do You Want to Join the Global Solutions Venture? (150 – 250 words) What Role(s) Do You Envision in a Startup Team? VisionaryCEOCTOOperations LeadProduct DesignerFinance LeadCommunity ManagerPolicy AdvisorEthics OfficerTime Commitment Confirmation *I confirm I can commit 12 weeks, 8–10 hours/weekI cannot commit to 12 weeks, 8-10 hours/weekGDPR Consent *I AGREE to share my data with CertifiEdge for program purposes.I DO NOT AGREE to share my data with CertifiEdge for program purposes.You are required to give consent, without which we cannot be legally bound to having you in the program.However it is a free choice.How Did You Hear About Us? Email NewsletterSocial MediaWord of MouthPartner Org.OtherReview of the Application Not SatisfiedSomewhat SatisfiedSatisfiedVery Satisfied How did you like the application detailsHow did you like the application details Not SatisfiedHow did you like the application details Somewhat SatisfiedHow did you like the application details SatisfiedHow did you like the application details Very SatisfiedWhat did you not like in the application requirements?What did you not like in the application requirements? Not SatisfiedWhat did you not like in the application requirements? Somewhat SatisfiedWhat did you not like in the application requirements? SatisfiedWhat did you not like in the application requirements? Very SatisfiedHow satisfied are you that this is the right path for you?How satisfied are you that this is the right path for you? Not SatisfiedHow satisfied are you that this is the right path for you? Somewhat SatisfiedHow satisfied are you that this is the right path for you? 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