June 24th 2019 Student Grant Award – Incredible Impacts 2019 Submission Form Please complete the following submission form before 30 September 2019 Your DetailsName* Title MrMrsMs First Last Your Address* Street Address Address Line 2 City Postal Code Country AfghanistanÅland IslandsAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarrussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRéunionRomaniaRussiaRwandaSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUS Minor Outlying IslandsUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabwe Email* Phone*Name of university you are attending*Degree you will obtain*Proposal DetailsBasic idea and objectives of your proposal*Stakeholders*(Describe the stakeholders and their roles within your proposal)Implementation*(Describe how you would implement your proposal, timeline with key milestones, resources needed etc)Measuring success*(Describe how you plan to measure the outcome of the project, what are the key performance indicators for the relevant stakeholders?)Upload documents (optional) Drop files here or Accepted file types: jpg, gif, png, pdf, doc, docx. (you can upload up to 10 files related to your proposal here)Grant*Should you receive the grant of US$2,500, how would you spend the amount, for example, put towards tuition fees, personal development etc.Terms and Conditions* I agree to the Terms and Conditions: By submitting your entry for Incredible Impacts Student Grant you agree to the following: - Only submissions from students who are currently enrolled in a recognised university/college will be considered - ICCA & BestCities can share your submission, excluding personal contact information, with the judging panel in order for the panel to carry out their judging duties - ICCA & BestCities may contact you to seek clarification on your submission and/or to request additional information - VisitHouston/ Houston First may use the content of your submission to develop legacy programme(s) that can be implemented and offered to future clients. - ICCA & BestCities may use the content of your submission to develop case studies to be shared with the global meetings industry. ICCA & BestCities will be obliged to seek your approval of these case studies prior to publication - ICCA & BestCities reserve the right to disqualify any entrant who does not comply with any of the Terms and Conditions - Grants will paid out by payment partner Meeting Escrow and grant winners will be expected to submit an expense report of how the grant has been spent. Questions? Please contact Ksenija Polla or Nigel Brown.