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Company Information Form
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Submitter's Name (your name)
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Submitter's Email Address
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Submitter's Phone Number
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Submitter's Relationship to Company in this Form
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(e.g., owner, funder, client, etc.)
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Company Name
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Company Website
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Company's Headquarter Address
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Company Date/Year of Incorporation
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Company's Number of Employees as of Dec. 2016
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Funding
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How much was raised and when, include angel investors and VC's. To be listed on the Seattle Tech Universe Map, companies must either have $1 million in funding or be profitable.
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Has this company earned at at least $2.5 million in annual revenue as of Dec. 2016?
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Yes
No
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How would you categorize this company? (check all that apply)
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Software
Healthcare IT
Gaming
Enterprise
Cloud Services
E-commerce
Other:
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Company Status
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Private
Public
Shut down
Acquired
Other:
If acquired, by who and when?
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Founder #1: Name & Title
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Founder #1: Previous employers and/or companies founded
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Founder #1: Educational background
Bachelor's, graduate degrees
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Founder #1: Ethnic background
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Founder #1: Gender
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Founder #1: Immigrant to US
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No
Don't Know
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Founder #2: Name & Title
*
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Founder #2: Previous employers and/or companies founded
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Founder #2: Educational background
Bachelor's, graduate degrees
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Founder #2: Ethnic background
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Founder #2: Gender
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Founder #2: Immigrant to US
Yes
No
Don't Know
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Founder #3: Name & Title
*
Your answer
Founder #3: Previous employers and/or companies founded
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Founder #3: Educational background
Bachelor's, graduate degrees
Your answer
Founder #3: Ethnic background
Your answer
Founder #3: Gender
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Founder #3: Immigrant to US
Yes
No
Don't Know
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Comments
Please share any other additional information you'd like.
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