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Surge Labs Application

To be considered for our 2023 event, please fill out the form below. You can select for your Surge Labs application also put you in consideration for potential partnership opportunities with Surge Ventures apart from the Surge Labs virtual pitch event.

Pro tip: Be concise with your answers. However, the more complete the information you provide, the better your chances of being selected and receiving valuable feedback. For example, if you had a prior exit or won a competition, tell us about it in the comments.

Company Name

Company Website

Your Mini Pitch

Why are you applying to Surge Labs?

Your Impact

City

State

Country

Launch Date

Milestones Achieved

What milestones have your company achieved since launch date? Check all that apply.
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Users

How many non-paying users do you have? (e.g. in freemium or ad-supported model)

Customers

How many paying customers do you have?

Customer Interviews

How many interviews have you conducted with potential customers in your initial market?

First Paying Customer Date

Initial Market Size

Total # of potential customers in your first market segment (beachhead market--NOT monetary size)

Customer Type

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Revenue Model

Total Revenue to Date

Founder Experience

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Employees

How many people work at this company? Include the CEO, but exclude any outsourced contractual workers.

Days Invested

Cumulative days spent by all team members to date.

Employee Compensation

Total $US spent on employee salaries and compensation.

Investors

Check all sources that have funded your company:
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Current Investment

How much money ($US) has been invested in your company?

Needs

Please ranks your needs at this stage.

Meet investors

Meet investors

Find employees

Find employees

Learn how to pitch investors

Learn how to pitch investors

Find customers

Find customers

Mentoring

Mentoring

Publicity

Publicity

Other (please explain in the comment section)

Other (please explain in the comment section)

Business Summary

Events

What industry-related events do you plan on attending this year?

Pitch Competitions

How many pitch competitions have you attended or pitched at? Tell us a little bit more about anything you're proud of or what else you'd like the Surge Ventures team to know.

More Info

Please provide links where we can find more info on your company

How did you hear about us?

Surge Ventures Partnership Application

Check this box if you'd like to use this application to apply to work with Surge Ventures apart from the Surge Labs virtual pitch event.
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Primary Contact Info

Primary representative who will be contacting Surge Ventures

Full Name

Email

By clicking the "Submit" button, I agree that the information above is true and that I have authority to share it. I understand that Surge Ventures will not share this information publicly, but our staff and evaluators will use it to make decisions and to contact me. I agree to receive emails from Surge Ventures (@surgeventures.com).