Welcome to the Application form. If you hit save to hold on to you results you need to use the same browser. If can be in a new tab. You changes should be saved. Venture Information Venture Name Website High-concept pitch. In one line, briefly describe what your venture does in a way that we'll get it. How long have you been working on this idea? With what industry does your venture most closely align? Consumer Technology Social Cultural Innovation Health Sciences Do you require wet lab space for your venture? Yes No Do you require storage space larger than a file cabinet for your venture? Yes No Market Opportunity What’s the problem you are looking to solve? Describe the market opportunity. Describe your solution (what will you make or do)? For whom are you solving this problem? How do you intend to acquire customers or reach your key stakeholders? How big is your market, what % of that market do you hope to capture, and what segment do you plan to capture first? Who are your competitors, and who might become competitors? Are you for-profit or non-profit? Progress To Date What potential industry partners and/or customers have you met with to validate your idea? How far along are you in developing your venture’s product/offering? Patent filed Completed prototype or proof-of-concept Actively developing product/offering Have working product/offering, currently being “beta” tested by users Have working product/offering in production/on the market None of the above What is your funding model and/or plan to generate revenue? How much funding have you received to date? $0 – $250,000 $250,000 – $500,000 $500,000-$1,000,000 $1,000,000-$3,000,000 $3,000,000+ Please itemize the amounts from each source. (i.e. Competition/Challenge Prizes; Friends/ Family; University funded/grants; Angel funding; Venture Capital; Crowdfunding; Revenue.) Have you participated in any other startup incubator or accelerator programs for this venture? Share with us your timeline and corresponding goals for the next 9-12 months. Describe your strategy for achieving these goals. Biographic Background Information Name of Lead Team Member First Last Team Lead's Primary Role Team Lead Email Team Lead Phone Team Lead's School Affiliation Graduation Year Will the Team Lead work at the Launch Lab on a regular basis (at least 1 day/week)? Yes No Team Members How many team members (including yourself) will be utilizing the Launch Lab? How many desks will you need for your team? Space/Community Why do you want to be part of the ScaleUpLab? We encourage teams to "pay it forward" to the community. Please indicate a topic on which you could contribute to a roundtable discussion, or a community-building event you could organize during your time at the ScaleUpLab, if accepted. If accepted, when are you available to move in? How long do you see yourself utilizing this workspace? 0-3 months 3-6 months 6-9 months 9-12 months 12-18 months 18+ months How many employees do you expect to have in one year? 0-2 3-5 6-8 9-10 10+ What other primary positions are you seeking to fill in the next year? If you have ever participated in the ScaleUpLab Accelerator Program (VIP), please let us know during which time period. (Select all that apply) If you have ever participated in the ScaleUpLab Accelerator Program (VIP), please let us know during which time period. (Select all that apply) If you have ever participated in the ScaleUpLab Accelerator Program (VIP), please let us know during which time period. (Select all that apply) Item weight Add more items more items Where are you currently located? Please describe your current work environment. What type of work environment are you looking for? What services would you want/need from the ScaleUpLab? How often will you be needing a conference room? More than once a day 1 time per day Few times a week Less than once a week Never How did you hear about the ScaleUpLab? Is there any additional information that you think would be helpful to explain? CAPTCHA Math question 7 + 10 = Solve this simple math problem and enter the result. E.g. for 1+3, enter 4. This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
