ECO-GREEN TECHNOLOGY HONUARABLE

INNOVATION COMPETITION (E-THIC’20)

Registration Form
Participants Name: (minimum 1 person & maximum 5 person)
I)
2)
Contact Info &
3)
Team Name
4)
5)
E-mail:
Phone Number:

Name of the
Teacher/Trainer:
Inventors Trainer

Name of the
*
School/
Institution
Address: ( Post Code):
Address

Category of the
[B]
Competition
Name of the
Invention/project **

Abstract of
Invention
 [C]
CLASSIFICATION

Patent No:
Patent
Patent Application No:
(if already have)

Infos: Category of Invention

 [A] REGISTRATION FEES [C] CLASSIFICATION:
Category Fees Class A: Agriculture, Food & Herbs
International USD100 Class B: Environmental
Malaysian RM250 Class C: Renewable Energy
Class D: Eco Automotive & Electric
Classification of
[B] CATEGORIES: Class E: Environment Education
Invention & fees
1. Professional, University, & Class F: Eco Manufacturing
College/Poly Class G: Green Building
2. Secondary School Class H: Eco I.C.T & Multimedia
3. Primary School Class I : Eco Biotechnology
4. Preschool Class J: Eco & Green Fields
 Important Dates: Fill the form & Send to:
renjerkonservasi@gmail.com
Date line registration & Payment:

01/06/2020 – 01/10/2020

Competition:

01/06/2020 – 01/10/2020

Judging (special awards):

10/10/2020 – 31/10/2020

Announcement special awards:

01/11/2020

Special Awards: e-mail: renjerkonservasi@gmail.com

information (all Gold medalist qualified for special Facebook: Ranger Konservasi Alam

award competition) Whatsapp: 017-3582658

Asia Pacific Innovation Award

(APIA)
Green Technology Award
(GTA)
Young Eco-Ranger Award
(YERA)
Go Green Innovator Award
(GGIA)
PERKAM Ranger Award
(PRA)

I, ______________________________________________________ hereby declare that the

above details of the invention is true and agree to abide by the competition
rules.

___________________________ ______________

Name & Signature: (can write name only) Date:

*Please submit to renjerkonservasi@gmail.com .

INNOVATION DISCLOSURE FORM

E-THIC’20
Instructions:
- Please complete the form.
- Applicant may extend the page if necessary.
- Form with insufficient written explanations will be disqualified from examination
- Form with NO VISUAL DOCUMENTS will be disqualified from examination
SECTION C: Written Explanations

PROJECT TITLE:

Motive & Purpose for Creating Invention

Characteristics & Creative Features of Invention

Contribution & Marketability of Invention

Others
 * SECTION D: Visual Documents *
Please attach invention’s visuals (any pictures, image screenshot, diagram, blueprint,
layouts, design, link, you tube, certificates etc) on the space provided below. Visuals are
highly recommended for E-THIC’20 judgment and evaluation, thus provide sample
good-quality visuals:
** You may send 4 pictures of project. (MUST!)
If have any certificates of winning and paper cutting can attach too. If have
video link, just write. (Option!)