Thank you for your interest in Incubator for Free Basics. Submission to this programme has closed, but please keep in touch!
Welcome to the Pre-Screening Questionnaire for the Incubator for Free Basics.

We believe in free access to basic life enhancing information.
Our technology & tools allow anyone to create and share information & services, with the potential to reach over 1 billion people.

By joining the Incubator for Free Basics - we can make it happen together!
The selection process for the Incubator has 4 Steps:

1) Pre-screening Questionnaire (~20min to fill in) 
2) Application form and agreement of Terms & Conditions (~1hr to fill in + requires signing authority) 
3) Shortlisting Interview (~30 minutes teleconference with relevant decision-makers) 
4) Independent Panel Review (final selection)

For a chance to be selected for the Incubator Programme please complete Step 1 in the form below now.
This questionnaire has 2 Sections:

Section 1 aims to gather information, allowing us to learn more about your organisation
Section 2 
aims to inform you of the benefits & responsibilities you'll have if you get selected for the programme.
Pleased to meet you. What's your name? *

What's the name of your organisation? *

What sectors does your organisation work in? *

What countries do you work in? *

What's your role in the organisation? *

Which of these answers best describes your organisation? *

Who are the direct beneficiaries of your work? *

Please provide us with your email address. *

Which of these options best describes the work you do? *

Tell us, as briefly as possible, what it is that you or your organisation does. *

How and why do you think Free Basics will help you to improve your reach and impact? How will you track and measure whether or not Free Basics is helping you improve both reach and impact? *

What content are you currently in possession of that might be suitable for distribution via mobile? *

Please describe the content or service that you'd like to make available through the Free Basics Platform. *

Please add your organisation's URL *

Providing an accurate URL here is important, as it allows us to see the type of content your organisation has and enables us to assess if it will work on our platform. 

Please provide us with your phone number *

Please don't forget the country and area code
Thank you, this information is really valuable to us!

Section 2 contains information about the nature of the programme that we need you to understand and agree to.

Are you a non-profit organisation, social enterprise, government agency or aid agency? *

Do you understand what Free Basics is? *

Are you committed to finding ways to making your information/services available online to those who cannot now afford the data costs? *

Do you offer information or services that improves people's lives and that could be complemented/expanded via a mobile channel? *

Do you understand that that is offering you the provision of a basic front end template and a CMS that you'll be able to use to load & publish your mobi-site content to Free Basics on? *

Please take note: Content refers to text and images only. Free Basics does not support Audio or Video. 
Do you understand that that you will not be receiving any direct financial funding from this programme offered by *

Do you understand that we do not support customisations over and above the tools & templates offered for this programme & what will be offered with future version releases? *

Do you understand that that the team will not be creating, editing, curating or loading your content into the provided CMS for you? *

You agree to develop, create and/or modify your content for your site for non-commercial use only. *

You agree, where necessary, to edit, load and maintain your own content/service on our Platform. *

You agree to invest appropriate time, staff & resources to set up and sustain your site with this programme? (i.e. contact, training time, content modification, content loading, content maintenance, content updates, etc.) *

You agree to assure that any staff members other than yourself, who may get involved in the Programme, are adequately briefed; familiar with the Partner FAQ documentation available on our public facing site; understand the above and have a thorough understanding of the Terms & Conditions of the Programme. *

Did you answer YES and I Agree to all of the above? Fantastic!
We're really excited that you'd like to be a part of our programme.

One last thing... 

How did you arrive at this pre-screening Questionnaire? *

Thank you for your submission of the pre-screening questions. We can't wait to read all about you! *

Please note that the completion and submission of this form is no guarantee that you or your organisation will be accepted into the Free Basics Incubator programme. If you do not hear from within 2 calendar months from your application then please assume that your application has been unsuccessful.
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