First Name *

Last Name *

Organization *

Website *

Email *

Phone *

Business Address *

Founding Team - Please list all founders/co-founders *

What does your startup do? *

What problem does your company solve? *

What is the business model for your startup? *

How does your business make money?

What stage is your startup in? *

Enter required value Idea Functional Prototype Beta (with real users) Early Launch (some customers) Active Revenue + Full Product Release

How much are you raising? *

Why are you raising money? *

Have you already raised external money - if so how much? What type of raise? (Friends/family etc.)

Does your startup have a female C-suite executive with 10% or more equity? *

Enter required value Yes No

Does your startup have a person of color cofounder with 10% or more equity? *

Some investment groups focus on investing in persons of color lead companies, this is for us to know if the startup is a potential fit.

Enter required value Yes No

Executive Summary *

A one page executive summary of your startup.

20MB max

Pitch Deck *

10 slide deck for investors. You will be able to modify before final event. Submit as pdf or slide deck.

20MB max

Do you understand that we will be sharing this information and your deck / executive summary? *

This information will be shared by the judge panel for applications as well as investors participating in the event.

Enter required value Yes No