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First Name:
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Company
Company description (25 words or less)
Company website
What is your business model?
Industry / Vertical
Revenue last year
Pre-revenue
< $100K
$100K - $500K
> $500K
# Customers (including pilots)
None
< 10
10 - 25
> 25
Amount of capital raised to-date
Bootstrapped / Pre-funding
< $100K
$100K - $500K
> $500K
Are you currently raising or do you plan to raise in the next 12 months?
Yes
No
Do not know if my business needs venture capital $$$
Are you or have you been a member of a formal accelerator program?
Yes
No
If YES, which one? (If no, then "N/A")
Do you work in a co-working space?
Yes
No
If YES, which one? (If no, then "N/A")
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