Companies Application Form
CiMed connects Israeli Medical Technology companies to the Silicon Valley health and medical technology ecosystem.
Delegation date: June 19th- 20th, 2018
Email address *
Application Information
APPLICATION IS FREE.

Participation fee includes year-long CICC membership and is due after 7 business days of acceptance.
-Participation fee for early applicants: $2,400
-Participation fee for regular applicants: $2,700
*10% discount for all CICC members

Early Application Deadline: Feb 22, 2018
Early Decision Acceptance: March 7, 2018
Regular Application Deadline: March 17, 2018
Notification of Acceptance: March 31, 2018
Participation Fee Due: 7 business days after acceptance

Company Name: *
Your answer
Company website URL *
Your answer
Year founded: *
Your answer
Founders names: *
Your answer
Number of employees: *
Your answer
Office locations: *
(city, state)
Your answer
Contact person full name: *
Your answer
Contact person email address: *
Your answer
Contact person phone number: *
Your answer
Category: *
Required
Potential/ existing customers *
Required
In which phase of product development are you?
Describe the company's regulatory status:
(exm. Clinical trials stage, FDA Approved...)
Your answer
Are you Pre or Post revenue?
What are the unmet needs you are trying to solve?
Your answer
How is your product innovative in its market?
Your answer
Demo URL:
Your answer
Funds raised to date: *
Source of funding: *
Required
Name your investors:
Your answer
Your digital footprint:
Provide any links for founders Twitter, Linkedin, facebook, etc. accounts
Your answer
How would you like to benefit from participating in the delegation? (Based on the descriptions of the benefits provided)
Your answer
How did you hear about CiMED? Did someone refer you to this summit? If yes, could you please name the person who referred you?
Your answer
Is there anything else you would like to add to your application?
Your answer
Click below to download the one pager template required for the application.
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