2008/2009 Application

Idea Type:

Not-For-Profit Idea
Business Idea

Sub-themes

Affordable Energy
Practical Use of New Technology
Innovative Ideas to Reduce the Cost of Living
Investing In People
Rural Housing of the Future

Title:

Please enter all relevant information.

Project Name (if applicable):
Contact Person:
Contact Person’s Title:

Mailing Address:
City or Town:
State:
Zip:

Contact Telephone:
Fax:
Cell Phone:
E-Mail Address:

A. Participant must be a resident of Alaska. Check boxes for residency verification.

Alaska Driver’s License:

Yes
No

Alaska State ID Card:

Yes
No

Permanent Fund Dividend:

Yes
No

Registered to Vote in Alaska:

Yes
No

B. Participant must certify that they have no judgments against them that would require surrendering all or a portion of the award to a third party.

I certify that there are no judgments against me:

Yes
No

C. My project will benefit rural Alaska residents.

For purposes of the competition "rural Alaska" does not include Anchorage, Fairbanks, Homer, Juneau, Ketchikan, Palmer, Wasilla, Kenai and Soldotna.

Residents from these communities may submit a Innovative Idea Application so long as their project benefits rural Alaska.

Yes
No

D. Can your project be executed within 12 months?

Yes
No

If I am awarded, I agree to do the following:

A. Participate in evaluation activities and to receive mentoring and technical assistance during the award year, October 2008 – October 2009.

Yes
No

B. Fill out the appropriate federal forms that will be provided to me in my own name or on behalf of the organization or company I am representing.

Yes
No

C. Award funds are for the 2008 Winner and not transferable to another party.

Yes
No

D. Report my Awards funds to the Internal Revenue Service, as they are taxable income to the winner and as such will be reported to the Internal Revenue Service.

Yes
No

A. Birth Date:

Month
Year

B. Gender:

Male
Female

C. Are you a first time business owner? (for business idea applicants only)

Yes
No

D. Do you belong to an Alaska Native tribe or region?

Yes
No

(Maximum 250 Words)

The competition criteria listed below are applicable to the Alaska Marketplace theme of “Innovations for Thriving Communities.” Your proposal must answer the criteria questions by which all applications will be judged.

• 1. Cultural Heritage — Your business idea must exemplify traditional values and practices of Alaska Native cultures in rural Alaska.
• 2. Benefit to Rural Alaska Communities — Depending on your organizational structure, please address only ONE of the following:
• Business Idea - Economic Stimulation/Job Creation— Your Innovative Business Idea must contribute towards economic stimulation and job creation in the targeted community.
• Not-For–Profit Idea— Your Innovative Not-For-Profit Idea must show how your community or social structure will benefit by the proposed innovation and how the idea can be replicated to other communities.
• 3. Innovation — Your business idea must present non-conventional approaches to the theme of the competition. Applicants seeking to expand existing initiatives are eligible, provided that they exhibit new elements in design or implementation not found in the original initiatives.
• 4. Sustainability/Profitability — Your Innovation Idea must show how your business can continue to operate and benefit the targeted community beyond the period of the award: Business Ideas must ALSO show how they can be profitable beyond the period of the award.

Cultural Heritage: Maximum 250 Words - Required)

Business Idea - Economic Stimulation/Job Creation OR Not for Profit Idea: (Maximum 250 words - Required)

Innovation: (Maximum 250 Words - Required)

Sustainability/Profitability: (Maximum 250 Words - Required)

Are you partnering with another business or organization?

Yes
No

(Maximum 250 Words)

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