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First Name

Last Name

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Email

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Phone Number

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Select Your Country

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Name of Startup

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Gender

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Male

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Female

Age Range

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What Category is your startup/idea?

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Technology Based

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Traditional Based[Non-tech]

What industry is your startup/Idea?

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What stage are you currently on?

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Do you have a team apart from yourself?

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Yes

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No

How old is your Startup/Idea?

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A

Below 1 year

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B

1-5 years

C

Above 5 years

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