San Diego Regional Energy Innovation Network Entrepreneur Application Form
First Name *
Your answer
Last Name *
Your answer
Company Name *
Your answer
Title *
Your answer
Email Address *
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Phone Number
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Company Website
Your answer
What is your California business address? *
Your answer
Are you operating or plan to set up operations in any of the following counties? (select all that apply)
If you are currently operating in any of the above counties, what is the address of your local office?
Your answer
Product/Technology/Service Description *
Your answer
Which energy domain(s) does your product/technology/service fall under? (select all that apply) *
Required
Technology Readiness Level *
Patent Status *
Company Elevator Pitch *
Your answer
What is your initial target market? *
Your answer
Who is your initial target customer? *
Your answer
Who are your primary competitors? *
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Who is the primary point of contact for your company? Please include their name and title. *
Your answer
If you have a leadership team, please list the names and titles of your team members and provide a brief description of their experience.
Your answer
How could your company or technology benefit disadvantaged communities? (select all that apply) *
Required
Is anyone on your team an alumna/alumnus of UC San Diego, San Diego State University, or University of San Diego?
Check all that apply
What are you looking to gain from the program? *
Check all that apply
Required
How did you hear about the San Diego Regional Energy Innovation Network? *
Check all that apply
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