New Energy Incubator Application

Transcription

1 New Energy Incubator Application Required fields are indicated with an asterisk (*). Contact Information First Name Middle Initial Last Name Suffix Country Address Lines City State/Province Postal Code *

2 Confirm * Phone* Job Title (If currently employed outside of applicant activity) Company (If currently employed outside of applicant activity) Emergency Contact Information Emergency Contact Name (First and Last Name) Emergency Contact Relationship Emergency Contact Phone Number Veteran Status Veteran Status Branch of Service Army Navy Air Force Marines Coast Guard National Guard

3 How did you hear about us? How did you hear about us? (check all that apply) Online Website Read an Article EPIcenter Staff Referral (please specify below) University (please specify below) Other (please specify below) Please Specify Fit If you are accepted into the Incubator, what are your expectations of the program? In other words, what are your primary reasons for applying for the program? Answer Here:* How is your project synergistic with EPIcenter?* Opportunity Briefly describe your idea, technology, product, and/or service.*

4 What problem(s) does your idea/ technology/ product/service solve?* Who are the prospective customers that will potentially value your solution?* Why may these prospective customers be willing to pay for your solution? What is your target market for entry (initial sales) and why? Do you currently have sales or binding purchase orders from this target market? Differentiation What is unique about your innovation (idea/technology/ product/service)?* What are the competitive advantages of your innovation?*

5 Who are the potential competitors to your innovation and why? Have you obtained or do you plan to obtain any intellectual property protection for your innovation? If yes, please describe. Team List of team members and advisors, along with a description of their respective role(s) and title(s). resumes to incubator@epicenterus.org* What are the strengths of the team?* With what areas do you feel that you need help filling out the team? The Pitch Do you have a working prototype?*

6 Do you have a Minimally Viable Product version at this time?* Describe your business model strategy, including a list of critical success factors.* Have you formed a company? If yes, what type of entity? If yes, what is your company name? Please provide a 4 or 5 word description of your company. List all owners (and their percentage of ownership). What is your company's website address, if applicable?

7 Have you realized sales? If yes, what was your gross revenue last month? Last year? If available, please your business plan, financial statements and forecasts, and pitch deck to Thank you. Commitment Are you headquartered in San Antonio? If not, where? (NOTE: The EPIcenter Incubator is NOT limited only to companies in San Antono.)* If not, what are your plans for a presence in San Antonio during the program? Beyond? (NOTE: a presence in San Antonio is not required by the EPIcenter Incubator. It may, however, be helpful to be onsite at times.)* Do you need office space?* Do you need access to maker space?* Are you currently a member of Geekdom?* Are you interested in learning more about Geekdom membership? If accepted into the program, what are your sources of capital for funding activities during your tenure in the program?*

8 Anything you'd like to add? Please Send: Please remember to send the following items to : 1. Team Members' Resumes/Bios 2. Business Plan, Financial Statements/Forecasts, and Pitch Deck (if available) What Happens Next? Once you check the box marked "I'm not a robot" and click "Submit", you are finished! Congratuations! You will receive an confirmation that your application has been received. Please refer back to the timeline for a reminder of when you can expect to hear back about your application (see FAQs). Please note that it is the policy of EPIcenter to perform a background screening and credentials verification on all applicants who are invited to join the Incubator, of which there may be a fee of up to $50. By clicking "Submit" you acknowledge this and agree to assume financial responsibility of any fees associated with the background screening. By submitting your application you are releasing your application to EPIcenter, and acknowledge that there is no guarantee of admission since EPIcenter retains sole and exclusive authority to accept or reject applicants. Thank you!

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