Start Up Value Project - Temporary Office Application Form

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General information

Company name *

Key personnel's name and titles *

Address *

City *

Prov. *

ZIP Code *

Country *

Phone *

Fax

Email *

Website *

Company profile

Number of Employees *

Up to 5

From 6 to 20

More than 20

Annual revenue (Euro) *

Less than 500,000

More than 500,000

Year started *

Sector *

Prototype *

Yes

Vision / mission, Team / Investors on board *

Product / Technology, Competitive advantage / Competition *

Business plan *

Yes

Capital raised to date (Euro) *

Need for capital *

Yes

Patents *

Yes

Company development stage *

Seed / angel round

Early stage

Series a round & beyond / growth stage

Late stage

Requested period

15 days maximum

From *

YYYY

To *

YYYY

In accordance with Italian regulations (D.L. 196 of 30.06.2003), the return / dispatch of this questionnaire is to be considered as an explicit authorization to use the information contained herein for purposes related to the activity of promoting the internationalization of your company.

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