LegatumCenterforDevelopmentandEntrepreneurship:FellowshipApplication2018-2019ApplicationRequirements
Tosubmitaneligibleapplication,youneedto:
-Completethe2018-2019applicationform
-UploadyourResume/CV(1pagemax)
PersonalInformationFirstName
MiddleName/MiddleInitial
LastName
PreferredName
CountryofCitizenship
GeographicRegion
CountryofPermanentResidence(Ifdifferentfromcountryofcitizenship)
GeographicRegion
Age(optional)
Gender(optional)
Doyouholddualcitizenship? Yes
No
Pleaseidentifyyourcountryofdualcitizenship
HaveyouappliedforanyoftheLegatumCenter’sprogramsinthepast? Yes
No
Identifytheprogramandyeartowhichyoupreviouslyapplied:
ContactInformationStreetAddress
City
State/Province/Region
Country
PostalCode
PhoneNumber(includecountrycode)
EmailAddress
SkypeID
GoogleHangoutID
LinkedInPage
MITEnrollmentStatus
PleaseselectyourcurrentMITstatus EnrolledMITgraduatestudent
EnrolledMITgraduatestudentbeginningadifferentMITgraduatedegreenextacademicyear
EnrolledMITundergraduatestudent
EnrolledMITundergraduatestudentacceptedintoanMITgraduateprogram
EnrolledMIT5-yearcombinedundergraduateandgraduatedegreestudent
Non-MITstudentacceptedtoanMITgraduateprogram
Non-MITstudent(applicationpending)
WhatisyourMITID?
Pleaseprovidetheemailaddressandcontactinformationyouprovidedforthatapplication
Pleaseuploadyouradmissionsletter
MITSchoolInformation
InwhichMITschoolareyoucurrentlyenrolled? SchoolofArchitectureandPlanning
SchoolofEngineering
SchoolofHumanities/ArtsandSocialSciences
SloanSchoolofManagement
SchoolofScience
Other
Pleaseexplain.
Whatdegreeprogramareyoucurrentlypursuing? BachelorofScience,S.B.
DoctorofPhilosophy,Ph.D.
DoctorofScience,Sc.D.
Engineer'sDegree,Eng.
MasterinCityPlanning,M.C.P.
MasterofArchitecture,M.Arch.
MasterofBusinessAdministration,M.B.A.
MasterofEngineering,M.Eng.
MasterofFinance,M.Fin.
MasterofScience,S.M.
Other
Pleaseexplain.
InwhichMITschoolwillyoubeenrollednextacademicyear? SchoolofArchitectureandPlanning
SchoolofEngineering
SchoolofHumanities/ArtsandSocialSciences
SloanSchoolofManagement
SchoolofScience
Other
Pleaseexplain.
WhatdegreeprogramwillyoubepursuingatMITnextacademicyear? BachelorofScience,S.B.
DoctorofPhilosophy,Ph.D.
DoctorofScience,Sc.D.
Engineer'sDegree,Eng.
MasterinCityPlanning,M.C.P.
MasterofArchitecture,M.Arch.
MasterofBusinessAdministration,M.B.A.
MasterofEngineering,M.Eng.
MasterofFinance,M.Fin.
MasterofScience,S.M.
Other
Pleaseexplain.
IfSloanMBA,areyouintheEntrepreneurandInnovationtrack? Yes
No
Undecided
WhatwillbeyourfieldofstudyatMITnextacademicyear? AeronauticsandAstronautics
AerospaceEngineering
AerospaceEngineeringwithInformationTechnology
AfricanandAfricanDiasporaStudies
AmericanStudies
AncientandMedievalStudies
Anthropology
AppliedOceanScienceandEngineering
ArchaeologyandMaterials
Architecture
...92additionalchoiceshidden...
Science,Technology,andSociety
ShipbuildingandShipbuildingManagement
TechnologyandPolicyProgram
TheaterArts
Toxicology
Transportation
UrbanStudiesandPlanning
Women'sandGenderStudies
WritingandHumanisticStudies
Other
Pleaseexplain.
Anticipatedgraduationdatefromtheprograminwhichyouwillbeenrollednextacademicyear____/__/__(YYYY/MM/DD)
Areyouadualdegreeapplicant? Yes
No
ForDual-DegreeApplicants
InwhichMITschoolareyouenrolled/acceptedforyourseconddegree? MITSloan-HarvardKennedySchool
MIT-WellesleyCollege
MIT-WHOIJointPrograminOceanographyandAppliedOceanScienceandEngineering
SchoolofArchitectureandPlanning
SchoolofEngineering
SchoolofHumanities/ArtsandSocialSciences
SchoolofScience
SloanSchoolofManagement
Other
Pleaseexplain.
Whatisthedegreeprogramforyourseconddegree? BachelorofScience,S.B.
DoctorofPhilosophy,Ph.D.
DoctorofScience,Sc.D.
Engineer'sDegree,Eng.
MasterinCityPlanning,M.C.P.
MasterofArchitecture,M.Arch.
MasterofBusinessAdministration,M.B.A.
MasterofEngineering,M.Eng.
MasterofFinance,M.Fin.
MasterofScience,S.M.
Other
Pleaseexplain.
Whatisthefieldofstudyforyourseconddegree? AeronauticsandAstronautics
AerospaceEngineering
AerospaceEngineeringwithInformationTechnology
AfricanandAfricanDiasporaStudies
AmericanStudies
AncientandMedievalStudies
Anthropology
AppliedOceanScienceandEngineering
ArchaeologyandMaterials
Architecture
...92additionalchoiceshidden...
Science,Technology,andSociety
ShipbuildingandShipbuildingManagement
TechnologyandPolicyProgram
TheaterArts
Toxicology
Transportation
UrbanStudiesandPlanning
Women'sandGenderStudies
WritingandHumanisticStudies
Other
Pleaseexplain.
Anticipatedgraduationdateofseconddegree____/__/__(YYYY/MM/DD)
Tellusaboutyou!
Whatareyourstrongestpersonal/professionalattributesasanentrepreneurialleader(e.g.,deeptechnicalknowledge,regional“ontheground”knowledgeandconnections,leadershipcapabilities,etc.)?Providespecificexamplesofentrepreneurialprojectsorteamsthatyouhaveled.(Limit1000Characters)
Howcertainareyouthatyouwanttobeanentrepreneurinthedevelopingworldpost-graduation?(It’sokaytobeonthefence!)Whatareyourgreatestfearsorconcernsaboutpursuingthisentrepreneurialpath–andhowcanwehelpyoumakeupyourmind?(Limit1000Characters)
Whyareyoupassionateaboutthisventure,andhowhaveyourexperiences(educational,leadership,professional,etc.)preparedyoutopursueit?(Limit1000Characters)
Haveyoulivedinorvisitedthecountryinwhichyouintendtolaunchorscaleyourventure?Ifso,forhowlongandinwhatcapacity(e.g.,residentofthecountry,studiedthere,workedthere,etc.)?Howhasthisexperiencebeenrelevanttoyourventure?(Limit1000Characters)
Howdoyouplantousethisfellowshiptogrowasanentrepreneurialleaderandprepareyoutoworkfull-timeasadevelopingworldentrepreneuraftergraduation?(Limit1000Characters)
HaveyoutakenanyMITcourses(includingonlineeducationcourses–MITx)thathavebeenrelevanttothedevelopmentofyourventure? Yes
No
Pleaseselectallthatapply 15.910InnovationStrategy
15.911BEntrepreneurialStrategy
15.232H1EffectiveBusinessModelsinFrontierMarkets
2.739/15.783/ESD.32ProductDesignandDevelopment
15.385SocialInnovationandEntrepreneurship
2.888ProfessionalSeminarinGlobalManufacturingInnovationandEntrepreneurship
15.364RegionalEntrepreneurshipAccelerationLab(REAL)
15.779(formerly15.S14)Technology,Design,andEntrepreneurship:OperatinginEmergingCommunities
15375/EC.731/MA5.665DevelopmentVentures
15.128/20.454RevolutionaryVentures:HowtoInventandDeployTransformativeTechnologies
15.359InnovationEngineering:MovingIdeastoImpact
15.360IntroductiontoTechnologicalEntrepreneurship
15.378BuildinganEntrepreneurialVenture:AdvancedToolsandTechniques
15.390NewEnterprises
15.395EntrepreneurshipwithoutBorders
15.399EntrepreneurshipLab
15.785DigitalProductManagement
15.S68SSIM:OpportunitiesinDevelopingEconomies
10.807/15.371InnovationTeams
6.933EntrepreneurshipinEngineering:TheFounder’sJourney
Pleaselistanyadditionalcourses(includingMITx)thatarerelevant
Tellusaboutyouridea!NameofBusiness/Idea
CountryofImplementation
GeographicRegion
BusinessModel For-Profit
Non-Profit
Hybrid:For-Profit&Non-Profit
Undecided
Industry/Sector Agriculture
Apparel&Accessories
Automotive
Chemicals
ConsumerGoods
Education
Energy/Utilities
Food&Beverage
FinancialServices
Heathcare/Pharma
IT/Telecom
Law/LegalServices
Manufacturing
Media
ProfessionalServices
RealEstate
Retail&Wholesale
Transportation
Tourism&Entertainment
YourBusiness'sWebsite
YourBusiness'sTwitterHandle
YourBusiness'sFacebookPage
Pleaseprovideabriefdescriptionofyourventure.(Limit1000Characters)
Thefollowing6questionsaretohelpusassessyourstageofdevelopment.Wedonotexpectthatyouwillrateyourventurea4or5inallcategories.Wearemostinterestedinunderstandingthecurrentstageofyourventure,andwhatyourplansaretoleveragethefellowshipandyourtimeatMITinordertoprepareyoutoscaletheventurepost-graduation.
Onascaleofonetofivedescribethestageofyourventureintermsofthefollowing:Generalstageofdevelopment 1(e.g.,Idea/Exploration)
2
3(e.g.,ProofofConcept)
4
5(e.g.,InOperationwithpayingcustomers)
Onascaleofonetofivedescribethestageofyourventureintermsofthefollowing:PrimaryMarketResearch(PMR)/CustomerDevelopment 1(e.g.,NoPMR)
2
3(e.g.,PreliminaryPMR)
4
5(e.g.,PayingCustomer)
Onascaleofonetofivedescribethestageofyourventureintermsofthefollowing:Product/ServiceDevelopment
1(e.g.,StillintheLab/Testing)
2
3(e.g.,Prototype/Pilot)
4
5(e.g.,Manufacturing/ServicingatScale)
Onascaleofonetofivedescribethestageofyourventureintermsofthefollowing:Team 1(e.g.,JustMe)
2
3(e.g.,2-5FoundingTeamMembers)
4
5(e.g.,+5TeamMembers)
Onascaleofonetofivedescribethestageofyourventureintermsofthefollowing:Board
1(e.g.,NoBoard)
2
3(e.g.,BuildingaBoard)
4
5(e.g.,Board)
Onascaleofonetofivedescribethestageofyourventureintermsofthefollowing:FundingRaised
1(e.g.,NoFunding)
2
3(e.g.,Grants/Family&Friends)
4
5(e.g.,Angel/Venture)
Whatistheproblemyouaretryingtosolveandforwhosebenefit?(Limit1000charactersforeachsection)
Definetheproblemandcurrent/potentialimpactofyourideainthedevelopingworld.Pleaseincluderelevantdataandresearch(primaryorsecondary)youhaveidentifiedtosupportthisproblemstatement.
Whoareyourcustomersandwhatisthemarketpotential?Pleaseincluderelevantdataandresearch(primaryorsecondary)youhaveidentifiedtosupporttheaddressablemarketsize.
Whatassumptionshaveyoutestedtodatethatsupportthisproblemstatementandtheopportunityforimpact?Whatassumptionsdoyouplantotestduringthefellowshiptobetterunderstandthisproblem?
Whatisyourproposedproductorservice(inotherwords,yoursolution)?(Limit1000charactersforeachsection)
Describetheproposedproductorservice.
Whatprogresshaveyoumadeontheproductorservicetodate?Whatdoyouplantododuringthefellowshiptoadvanceyourproductorservice?
Whatisyourcompetitiveadvantage?(Limit1000charactersforeachsection)
Whoareyourprimarycompetitors?
Whydoyoubelieveyourproductorservicewillbeabettersolutionthanyourcompetitors’,andhowdoyouplantotestyourassumptions?
Whatisyourproposedbusinessmodel?Howdoyouexpecttomakemoney?(Limit1000Characters)
WheredoyouwantyourventuretobebyJune2019?Whatisyourvisionforhowyouwillgrow,launch,andpotentiallyscaleyourventurebetweennowandthen?(Limit1000Characters)
Whatarethetopchallengesorrisksyouseeasyougrow/scaleyourventure?Includeyourplanforhowtoaddresstheserisks.(Limit1000Characters)
Tellusaboutyourcurrentteam,includingabriefdescriptionof:(Limit1000charactersforeachsection)
Yourroleontheteam
Teammembers,includingnumberofcoremembers,theirroles,andrelevantexperience
Thekeyskillsyouneedtoaddtoyourteam
Tellusaboutyourfundingstatus,including:(Limit1000charactersforeachsection)
Thefundinghaveyouraisedtodate
Thefundingyouanticipateyouwillneedinthenext12monthstoreachthelevelofgrowthyoudescribedabove
Thefundingsources/platformsyouhaveutilizedtodate(e.g.,personalsavings/debt,grants,competitions,friendsandfamily,angel/venture,other)
HowdoyouenvisioncontributingasanindividualandthroughyourventuretotheLegatumCenterMission?(Limit1000Characters)
FINANCIALRESOURCES
Whatisthetotalestimatedcost(inUSD)ofyourMITprogramforthe2018-2019academicyear?Tuition,booksandsupplies,housing,etc.
Doyouhaveadditionalfellowships,scholarships,sponsorships,orotherfinancialsupport(includingpersonalandfamilyfunds)thatyouanticipateusingtosupportyourstudiesatMIT?TheLegatumCenterencouragesyoutoapplyforadditionalfinancialsupportsothattheCentercanmakeitsresourcesavailabletootherworthycandidatesaswell. Yes
No
Source1:Pleaseincludethenameofthesourceandtheamount.SourceName
Amount(inUSD)
Confirmed? Yes
No
Doyouhaveadditionalresources? Yes
No
Source2:Pleaseincludethenameofthesourceandtheamount.SourceName
Amount(inUSD)
Confirmed? Yes
No
Doyouhaveadditionalresources? Yes
No
Source3:Pleaseincludethenameofthesourceandtheamount.SourceName
Amount(inUSD)
Confirmed? Yes
No
Doyouhaveadditionalresources? Yes
No
Source4:Pleaseincludethenameofthesourceandtheamount.SourceName
Amount(inUSD)
Confirmed? Yes
No
Doyouhaveadditionalresources? Yes
No
Doyouhavemorethanfoursources? Yes
No
Howmuchfinancialsupport(inUSD)areyouseekingfromtheLegatumFellowship?
Areyou(planning)ontakingoutloansnextacademicyear?Ifyes,howmuch?
Pleaseprovideatleast3professionalreferences.Pleasenote,wewouldonlycontactthesereferencesifyoumadeittotheinterviewstageandwithyourpermission.
Reference1FirstName
LastName
Title/Company
Emailaddress
Phonenumber
Relationshiptoapplicant
Reference2FirstName
LastName
Title/Company
Emailaddress
Phonenumber
Relationshiptoapplicant
Reference3FirstName
LastName
Title/Company
Emailaddress
Phonenumber
Relationshiptoapplicant
Reference4(optional)
FirstName
LastName
Title/Company
Emailaddress
Phonenumber
Relationshiptoapplicant
AdditionalQuestions
DoyouknowaLegatumFellow? Yes
No
Whatishisorhername?
HowdidyouhearabouttheLegatumFellowship?(Checkallthatapply)
LegatumCenter's LegatumEvent(Pleasestatethetopicorspeaker)______________________
ConferenceatMIT(Pleaseindicateyear)______________________
Email(Pleasespecifysender)______________________
Website
LegatumCenterEntrepreneur-in-Residence
Other,pleasespecify...______________________
Websites MITSloanSchoolofManagement
MartinTrustCenterforMITEntrepreneurship
MITOfficeofGraduateAdmissions-GeneralSite
Other(Pleasespecify)______________________
SocialMedia/Advertisement(Pleasespecifypagesourceorlocation) Facebook______________________
Twitter______________________
LinkedIn______________________
Article,Flyer,Radio______________________
Other______________________
DirectContact(Pleasespecifywho) LegatumFellow/Alumni______________________
MITFaculty/Staff______________________
MITStudentorAlumni______________________
MITOrganizationorClub______________________
Non-MITContact______________________
OtherContact(Pleasespecifyeventlocationanddate) InformationSessionat______________________
Career/RecruitingFairat______________________
Conferenceat______________________
Other______________________
Wouldyouliketoopt-intotheLegatumCentermailinglist? Yes
No
Bysigningbelow,IcertifytheinformationIhaveprovidedtobeaccurate.
