JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
Apply for access to the 2020 Funded House
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Email
*
Your email
Company name
*
Your answer
First name
*
Your answer
Last name
*
Your answer
Industry
*
Your answer
Current full time head count
*
<10
10-50
51-100
100+
Have you raised seed funding?
*
Yes
No
Total to-date raised
*
$100k+
$500k+
$1M+
$5M+
N/A
Are you currently raising capital?
*
Yes
No
How much are you looking to raise?
*
< $1M
$1M-$3M
$3M-$5M
$5M+
Do you have commitments for the current raise?
*
Yes
No
If yes, how much?
*
<10%
10%-25%
25%-50%
50%-75%
75%+
N/A
Who would you like to meet at Funded House?
*
Other rapid-growth startups
Service providers that support startup growth
VCs
Other:
Required
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of MediaTech Ventures.
Report Abuse
Forms
