Impact X - Entrepreneur Intake Form
Welcome to Impact X.

We really appreciate the effort involved in applying for funding.

Filling in this form helps us as we try to identify the best and most diverse startups using a fair and data-driven approach. It also makes it easier for us to raise from investors increasing the chance that deserving underrepresented founders like yourselves will get funded.

Once you have submitted your form we promise that we will get back to you within 7 days with the next steps.

If you have any questions you can contact us at

We look forward to hearing from you and thank you for taking the time to reach out to us!

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What is your Website Address? *
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