SafirLab 2018 - EN
SafirLab is an incubation programme open to young agents of change in the Arab world. Before completing this form, please ensure you meet the following criteria:

- you are aged between 20 and 30;

- you are a native and resident of one of the following eleven countries: Algeria, Egypt, Iraq, Jordan, Lebanon, Libya, Morocco, Syria, Palestinian territories, Tunisia, Yemen;

- you have launched an entrepreneurial project in one of the following areas: creation of online citizen media, cultural innovation, education, the rights of women and minorities, sustainable development and health issues.
Your surname *

Your first name *

You are *

Your date of birth *

Submit your CV *

Submit your photo *

Your email address *

Your Skype ID *

Your telephone number *

Your project

Project name *

Please provide an outline of your project *

What is the social and/or cultural issue that your project aims to solve? *

Describe your project team, stating the role of each member *

Does your project have a legal structure?

other: please specify

Do you have a business model? Have you developed income-generating activities? *

What are your project’s current (or completed) activities/actions? *

How do you see your project two years from now? *

Do you have any partners (institutions, media outlets, companies, etc.)? If so, please specify. *

Have you received any funding (grant, loan, etc.)? If so, please specify. *

Have you previously taken part in any international programmes or training courses for your project or another project? *

(topic, year, organiser, country)
Please rate the level of advancement of your project on a scale of 1 to 10 *

1 to 3: the idea is mature, you are beginning to lay the foundations of the project
4 to 7: your project is at the start-up phase, the initial actions to develop the project are being put in place
8 to 10: your project is gaining momentum, the effects of your innovation are being felt)

What are your expectations of SafirLab?

1 is the highest level of expectation, 5 is the lowest
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En quatrième choix *

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En cinquième choix *

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What are the specific issues you wish to solve with SafirLab? *

Which two organisations (company, association, local authority, etc.) do you wish to meet in Paris, and why? *

Do you have a website, Facebook page or Twitter account or any other online platform?

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