Full Name
*
Phone
*
Email
*
Does your company have at least one significant competitive advantage?
*
Yes
No
Does your company have proprietary technology or intellectual property (IP)?
Yes
No
What are your current annual revenues?
$0 - $85,000
$86,000 - $116,000
$117,000 - $300,000
$301,000+
Do you live in the United States ?
*
Yes
No
Estimate of your net profits?
*
$0 - $40K
$50k - $150
$250k - $500k
$500k<
Have you raised from Friends and Family (i.e. seed round)?
Yes
No
Do you currently have institutional investors?
*
Yes
No
Do you currently have institutional investors?
Yes
No
What is your addressable market size?
Less than $200 million per year
More than $200 million per year
What is your anticipated capital need in the next year?
Less than $5 million
More than $5 million
How much combined work experience do the founders have?
10 years
15 years
20 years +
How much combined C-suite operational experience do the founders have?
1-3 years
4-6 years
7-9 years
10-12 years