Application form – Reimagining TB Care

Tells us about yourself!

First name(Required)

Last name(Required)

Email(Required)

Phone number (include country code)(Required)

Gender(Required)

LinkedIn profile

How did you learn about us?(Required)

If other, please elaborate.

Are you the appropriate company representative to contact?(Required)

Yes

No

If no, please complete the below section.

First name

Last name

Email

Phone number (include country code)

Tell us about your company!

Describe your company in a few sentences.(Required)

What are your company's core values and guiding principles?(Required)

What is your company’s legal name?(Required)

Does your company have legal entity?(Required)

Yes

No

What year was your company established?(Required)

Where is your company headquartered? (city/country)(Required)

How many full-time employees does your company have?(Required)

Is your company's management team (those with senior-level, strategic decision-making abilities) comprised of at least 50% women-identifying employees?(Required)

Yes

No

Is your company currently doing business in TB affected countries?(Required)

Yes

No

If yes, please list the countries.

If no, is your company interested in doing business in TB affected countries?(Required)

Yes

No

If applicable, please share your company’s website.

If applicable, please upload your company’s logo.

Max. file size: 2 MB.

Describe your company's product innovation in a few sentences.(Required)

Which category/sector applies to your company's product innovation?(Required)

If other, please elaborate.

How does your company’s product innovation facilitate decentralized (to people’s homes, neighborhoods, etc.), integrated (for TB and across communicable and/or non-communicable diseases), and people-centered (considers people's preferences, needs, and circumstances, including their emotional, mental, and financial well-being) services?(Required)

How does your company’s product innovation address environmental, social, including gender barriers, and/or governance factors?(Required)

What is new about what your company’s product innovation compared to other solutions already available on the market?(Required)

Are there any independent evaluation studies or published data on your company's product innovation?(Required)

Yes

No

If yes, please share the links.

Walk us through your business plan!

Where is your company’s product innovation in the product development lifecycle?(Required)

If other, please elaborate.

Does your company have any revenue?(Required)

Yes

No

What is your company’s type of sales?(Required)

If other, please elaborate.

Is your company on the Stop TB Partnership's Global Drug Facility's (GDF) Product Catalogue?

Yes

No

Has your company received any traditional donor funding? If yes, please elaborate.(Required)

Has your company received any private sector investments? If yes, please elaborate.(Required)

Give us your pitch!

Please upload your pitch deck in PDF form. For guidance on how to develop a pitch deck, please refer to Guy Kawasaki's template (https://guykawasaki.com/the-only-10-slides-you-need-in-your-pitch/).(Required)

Max. file size: 2 MB.

Anything else you want to tell us?

The company's product innovation, including the company's website and logo, can be listed on the RTC initiative's website and in the innovation database?(Required)

Yes

No

I have read and understand the UNOPS' terms of use (https://www.stoptb.org/terms-and-conditions-of-use) and privacy policy (https://rtc.stoptb.org/privacy-policy/).(Required)

Yes

No

Innovations Sourcing Portal

Information Form

Tells us about yourself!