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PITCH BOOTCAMP APPLICATION FORM
PLEASE FILL OUT THE FOLLOWING FORM IN ORDER TO BE CONSIDERED FOR THE PITCH BOOTCAMP PROGRAM
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Email
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Your email
CONTACT INFORMATION
Full name
*
Your answer
Email
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Your answer
Phone number
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Your answer
COMPANY INFORMATION
Company name
*
Your answer
What does your company do (in one sentence)?
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Your answer
What unmet need does your company address?
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Your answer
What is your solution? What is innovative about it?
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Your answer
Who are your main competitors?
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Your answer
Have you submitted any patent?
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Your answer
What is the status of your company?
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Proof of concept
pre-clinical
animal studies
first in man
pre-market
Other:
Have you raised funds?
*
NO I have not raised any funds
Under 100K USD
Between 100K and 500K USD
Between 500K USD and 2M USD
Between 2M USD and 3M USD
Over 3M USD
Describe your team members and their backgrounds
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Your answer
Please upload your presentation to a shared drive and paste link to presentation here
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Your answer
How did you hear about us?
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A copy of your responses will be emailed to the address you provided.
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