| 1. COMPANY INFORMATION |
| Company* |
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| Claim of your Company* |
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| E-Mail for further communication with us* |
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| Address |
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| Country (format example: DE = Germany) |
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| City |
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| Phone (format example: +49 89 4520 555 12)* |
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| Company Email Address (general requests) |
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| Website |
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| Facebook (Link) |
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| Twitter (Link) |
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| Link to Press Release |
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| 2. TEAM |
| How many founders does your team have?* |
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| Salutation* |
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| First Name* |
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| Last Name* |
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| E-Mail* |
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| LinkedIn Profile |
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| XING Profile |
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| Salutation (Founder 2)* |
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| First Name (Founder 2)* |
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| Last Name (Founder 2)* |
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| Email (Founder 2)* |
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| LinkedIn Profile (Founder 2) |
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| XING Profile (Founder 2) |
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| Salutation (Founder 3) |
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| First Name (Founder 3) |
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| Last Name (Founder 3) |
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| Email (Founder 3) |
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| LinkedIn Profile (Founder 3) |
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| XING Profile (Founder 3) |
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| Information on further founders |
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| What knowledge do you have in your team?* |
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| 3. BUSINESS IDEA |
| Industry* |
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| Other or additional Industry |
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| Business Model* |
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| Briefly describe your business idea* |
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| KPIs (How do you measure success?)* |
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| KPI comments |
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| Supply Chain* |
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| 4. PRODUCT |
| Product Name* |
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| Product Type* |
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| Prototype* |
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| Proof of Concept* |
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| Main USP of your Business* |
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| Other USP |
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| Describe your USPs (max. 255 characters) |
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| Intellectual Property/Patent |
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| Main Challenges of your Business* |
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| Do you have legal issues?* |
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| If so, please provide explanation |
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| 5. MARKET |
| Do you address a new or existing market?* |
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| Market size of your product/service?* |
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| Cumulated market growth (next 5 years)?* |
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| Target group for your business* |
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| Competitor 1* |
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| Website Competitor 1 |
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| Competitor 2 |
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| Website Competitor 2 |
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| Competitor 3 |
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| Website Competitor 3 |
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| Your strengths relative to competitors* |
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| 6. FINANCIALS |
| Do you have investors on board?* |
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| If so, how much money raised to date (EUR)? |
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| Round 1 (EUR) |
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| Round 2 (EUR) |
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| Round 3 (EUR) |
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| Investor’s investment & equity shares |
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| Your current stage/valuation (EUR)?* |
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What is your current burn-rate (per month in EUR)?* |
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What is your current company bank balance (EUR)?* |
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Do you have customers?* |
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| What is the average basket size (EUR)? |
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| Do you have returning customers? |
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| Revenue generated so far (EUR)* |
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| Revenue generated last quarter (EUR) |
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| Is your business profitable? |
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| 7. MISCELLANEOUS |
| Additional comments |
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| How did you hear about this program?* |
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| Other Sources |
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| Newsletter subscription |
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| Accept Terms & Conditions* |
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