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Startup Check-In

Full name

Email Address

location

Start up name

Start up name

Industry of your startup

LinkedIn profile

Stage of your start up

Stage of your start up
A
B
C
D
E
F

Are you currently seeking funding?

Are you currently seeking funding?
A
B
C
D
E

Are you interested in crowdfunding as a means to raise funds?

Are you interested in crowdfunding as a means to raise funds?
A
B
C

What are the biggest challenges you are currently facing with your startup?

Are you generating revenue?

Are you generating revenue?
A
B
C

what type of support are you actively seeking?(select All that apply)

what type of support are you actively seeking?(select All that apply)

short term Goals(6 -12 month)

Do you currently have customers?

Do you currently have customers?
A
B
C

Are you part of an accelerator Program?

Are you part of an accelerator Program?
A
B

if yes, What is the name?

Are you interested in an accelerator program?

Are you interested in an accelerator program?
A
B
C

Are you open to collaboration opportunities with other startups or founders?

Are you open to collaboration opportunities with other startups or founders?
A
B
C

May contact you for the follow - up discussion or to provide tailored support?

May contact you for the follow - up discussion or to provide tailored support?
A
B