Connect Shapers Application 2018 Question Title * 1. Full name OK Question Title * 2. Email address OK Question Title * 3. Mobile phone number OK Question Title * 4. LinkedIn Profile OK Question Title * 5. What is your job title and employer/company? Or if a student please complete degree level e.g. MSC/PostDoc/PHD, area of study and institution. OK Question Title * 6. Tell us about your curiosity in the 4th Industrial Revolution and why you want to learn more? OK Question Title * 7. What are the key opportunities and challenges for Northern Ireland innovation under the 4th Industrial Revolution? OK Question Title * 8. Why do you want to be a 4IRC Connect Shaper? OK Question Title * 9. Do you have the time to commit to the role of a Connect Shaper and participate in the programme fully? (12 month commitment. Compulsory quarterly ideations, and membership of one event sub team designing one of the monthly debates (work 3 months ahead) and optional monthly meetings to support other sub-teams in the design of their debate) OK Question Title * 10. Reference contact details OK Question Title * 11. How did you hear about Connect Shapers and 4th Industrial Revolution Challen Twitter Personal recommendation Place of work Website LinkedIn Other OK DONE