Form: Impact Ambassador Scholarship

Your first Name *

Your last/family name *

Your email address *

Please confirm your email address *

Your phone numberPlease include country code.

Your company's namePlease note that you must be affiliated with a non-corporate entity, e.g. a governmental organization, an NGO or a startup.

Your job title Please note that you must be an executive-level employee at your company.

Which program dates are you interested in? *

September 9-11, 2019 December 2-4, 2019February 19-21, 2020

You can only select one.

Please share with us which Global Grand Challenge(s) or UN Sustainable Development Goal(s) you are working on solving, how you are tackling the challenge, and why this is important to you. (Maximum 250 words) *

Please tell us why you want to participate in the Singularity U Nordic Executive Program and what is the relevance of the program for you. (Maximum 400 words) *

Please share something from your background/expertise that you think will provide value for the other participants at the SingularityU Nordic Executive Program. (Maximum 250 words) *

Five years from now, you are on the cover of your favorite business magazine because of an achievement that was kickstarted during your participation in the SingularityU Nordic Executive Program. What is the headline? *

Areas of Interest: To help us better understand your interests, please select your top interests from the list below. | Exponential Technologies *AI & RoboticsBiotechnology & BioinformaticsEnergy & Environmental SystemsMedicine & NeuroscienceNanotechnology & Digital FabricationNetworks & Computing SystemsNo Specific Interest

You will join the program via a technological solution that enables you to move within the space and engage with participants in real time. Therefore, internet support is required. The program will be live in Copenhagen (Central European Time Zone). *Yes, ensure to have full internet support to be able to participate while the program is live in Copenhagen. I am not able to have full internet connection.

Feel free to share anything else you'd like us to know here (optional).

Terms and Conditions. *

To see our Terms & Conditions, visit http://sunordic.org/termsconditions/

I agree to my personal and professional data being captured and stored by SingularityU Nordic (See Terms & Conditions).

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Enroll &
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Startups

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Resources

Enroll & Attend

Startups

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Resources

Enroll &
Attend

Host an
Event