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Queens Tech + Innovation Challenge Intake Form
Thank you for your interest in the 2023 Queens Tech + Innovation Challenge. As our programs are free, we are required by our funders to collect demographic information in order to better serve our community. Please fill this out to the best of your ability. We will not contact you without your permission.
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Email
*
Your email
Your Name
*
Your answer
Phone number
Your answer
Address
Your answer
Do you or one of your team members live in Queens?
*
Yes
No
Gender
Choose
Female
Male
Prefer not to say
Age
Choose
21 & under
21 - 30
30 - 40
40 -50
50+
Race
Asians
Black or African American
Native American or Alaska American
Native Hawaiian or other Pacific Islander
White
Other
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Ethnicity
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Hispanic Origin
Non-Hispanic Origin
Are you a veteran?
Choose
Non-veteran
Veteran
Service-Disabled Veteran
Unknown-Not Stated
What is the highest level of education you have received?
Choose
High School Graduate
Some College
College Graduate
Advanced Degree
What is your employment status?
Choose
Unemployed
Employed Full Time
Employed Part Time
Self-Employed
Retired
what is your business type?
*
Your answer
Your business name
Your answer
How would you define your current business readiness?
Choose
Concept
Product Built
Product/Service Tested
Paid Customers
When did your business start?
(Month and Year. If it hasn't been started, put a future date)
Your answer
Please share your website/Social media/LinkedIn or any business online presence?
Your answer
What is one thing you'd like to get from the Queens StartUP! Program?
Learning, feedback, network/relationships, cash prize, mentorship, etc
Your answer
How did you hear about Queens Startup?
*
Your answer
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