Submission

What's your great idea?

The University of Illinois and Carle Illinois College of Medicine are committed to embracing and ensuring diversity among our community participants, citizen scientists, students, faculty and staff. We welcome ideas and participation from everyone and would like to know more about you. Your answers will not be shared with the judges or used as part of the Make-a-Thon competition.

To submit your idea please upload a short video in which you and/or your team answer these three questions.

What is the health-related problem you want to address?
What is your idea for solving this problem?
How will your solution impact the health of individuals, families, and/or communities?

If you are unable to upload a short video, you may submit your idea in writing. Please answer the questions above in 1,750 characters or less.

How will you submit your great idea (video or written)?*

Video Upload*

What's Your Great Idea?*

Submission Title*

Please select at least 3 keywords that best apply to your great idea in order of importance (#1 most important)

Keyword #1*

Keyword #2*

Keyword #3*

Keyword #4

Keyword #5 Other (optional, single word)

Full Name of Individual or Team Leader*

You may submit as an individual or with a team; however, if you submit as a team, there must be a team leader identified as the main point of contact.

Individual or Team Leader Age*

Email*

Enter Email Confirm Email

Phone*

Current Address*

Street Address Address Line 2 City State ZIP Code

Is Your Current Address the Same as Your Permanent Address?*

Yes
No

Permanent Address

Street Address Address Line 2 City State ZIP Code

Are You a University of Illinois Urbana-Champaign or Carle Foundation Hospital Employee?*

Yes
No

Where Did You Learn About the Health Make-a-Thon?*

Occupation

Employer or School

Highest Education Level Obtained*

Race/Ethnicity*

If multiracial, please select all that apply

American Indian or Alaskan Native
Black (African American, Afro-Caribbean, African)
East Asian or Asian
Latino/a or Hispanic
Middle Eastern
Non-Hispanic White or Euro-American
South Asian
Prefer not to respond

Gender Identity

Number of Team Members, Including Yourself*

Team Members

Please use the ⊕ icon on the right to add rows for additional team members.

Full Name	Email	Age	Guardian Name & Email if under 18 years

Acknowledgement and Consent*

I understand and agree to the official rules and the following:

I confirm that the information given in this form is true, complete, and accurate.

By submitting an idea, an individual and/or team members agree to abide by any rules set forth by the University of Illinois at Urbana-Champaign, Health Make-a-Thon, or the Health Maker Lab Network.

Each individual or team certifies, by submitting an application, that the idea is his/her/their own original idea and does not violate or infringe upon the creative work of others, as protected under applicable intellectual property law.

Each team lead is the primary point of contact and is responsible for ensuring any team updates are communicated to the Health Maker Lab and that Health Maker Lab communications or updates are shared with other team members timely.

By entering the contest, the entrants agree to hold the University of Illinois and their delegates harmless from all legal and administrative claims to include associated expenses that may arise from any claims related to their submission or its use.

Decisions by the judges will be considered final and may not be appealed, and the Health Maker Lab reserves the right to make final decisions on other points not outlined in these rules and guidelines.

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What's your great idea?

Gain inspiration from other health makers, like yourself.