1. The Lean LaunchPad Imperial Application Team Name TEAM MEMBERS NAMES Member 1Member 2Member 3Member 4 What is your professional status and affiliation? (Status: undergrad, grad student, post-doc, clinician, resident, faculty, industry. Affiliation: Imperial, Industry, other) Provide your LinkedIn public profile URL, email, and phone #. What is your field? Role on Team Anything interesting we should know about you (be brief)

2. Team Name (team website if you have one) FILL OUT ALL 9 BOXES OF THE CANVAS

3. Please also include:  A one page overview on your venture idea (either on this ppt or in a separate.doc or.pdf) Please include who owns your ventures IP and if your team has the rights to it