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First Name *

Surname *

Company Name *

Gender

Address

Street *

City *

Parish/State *

Country *

Team

Number of employees *

Number of full-time employees *

How many full-time equivalent employees does the company currently have on payroll, including founders? *

Family relationships among the founders, board members and/or managers *

Number of years your CEO has experience in all work positions *

Amount of male co-founders in the core team *

Amount of female co-founders in the core team *

Number of years your CEO has experience as a start-up entrepreneur *

Other commitments that key team members have *

Business Details

Business Email *

Personal Email *

Company Address *

Personal Mobile *

Date Business Founded *

Form of Registeration *

Business Sector *

Website

Problem

Problem summary *

What are people forced to do now because what you plan to make doesn't exist yet? *

How strong is the need and how well do customers recognize it? *

Solutions

Solution summary *

What is your product/service? *

Time needed to launch MVP, beta or prototype *

If you already have something, how long ago was it *

Market

Customers and market summary *

Users/customers overview *

Size of markets by target country *

Current customers *

What is your unique value proposition? What's new about what you're doing? *

Approximate Market Size, in Millions ($USD based on today's rate) *

What is the competitive advantage of your company? *

How did you estimate the market size? *

Competitors

Competitor(s) Name *

Do they have a market lead? How big is their lead? *

What obstacles is the competitor facing that help you preserve your lead? *

Why/how are you different/better? *

Which companies do you consider to be your main competitors and why? *

Link to website or video

Business Model

Business model summary *

What is hindering your growth potential? And/or, what do you foresee as a barrier to your growth potential? *

Finance (USD)

Total revenue generated ($) *

Last fiscal year revenue *

Current financial year revenue ($) *

Monthly Recurring Revenue *

Has the company received any funding or investments to date? *

Monthly burn ($) *

Annual revenue forecast for this year *

Raising Capital *

Funding Stage *

Strategy

Traction summary *

Please describe your company’s go-to-market strategy *

Next milestones *

What might go wrong? *

Other

Do you have any ideas you consider patentable? Which ideas? *

Have you participated in any accelerator or incubator program? *

Referred by *

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