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Accelement Coaching Application
Filling out this form will help us match you with the most complimentary team of coaches at Accelement, and make it easier to pair with the appropriate companies.
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ZIP CODE
*
Your answer
First Name
*
Your answer
Last Name
*
Your answer
Email
*
Your answer
Phone (cell)
*
Your answer
Best times to reach you
Your answer
Reason for wanting to coach for Accelement?
Your answer
Most relevant teaching or coaching experience?
Your answer
Tell us about any startup experience you've had.
*
Your answer
Areas of primary focus in your career by industry (check all that apply.)
Industrial products (i.e. B2B sales of equipment, components)
Basic Materials (i.e. oil & gas, metals, steel, specialty chemicals)
Consumer Products (i.e. food, beverage, health and beauty)
Retail (i.e. retail storefront operations, franchising)
E-Commerce (i.e. online sales of consumer goods)
Financial Services (i.e. insurance, investments, banking, credit services)
Business Services (i.e. advertising, media, training, video production, transportation)
Technology (i.e. software, SAAS services, computers, networks, internet of things)
Healthcare (i.e. pharmaceuticals, medical equipment, health insurance, hospitals and long-term care facilities)
Other (Please Describe Below)
Functional areas of experience
Product development/R&D
Innovation management
Finance
Marketing
Sales
Customer service
Supply chain management
Human resource management
Other:
Are there other business areas you are interested in coaching?
Your answer
Will you be able to commit 4 hours per month to Accelement?
YES!
NO
Clear selection
If "NO" how much are you able to provide?
Your answer
Is there a stage of growth you prefer to coach? (Check all that apply.)
Concept Stage
Market research
Product Development
Business Plan Development
Business Plan Competitions
Talent Acquisition
Angel Round
Pivot
VC Round
Nothing but blue sky
What's the most important question you ask an entrepreneur?
Your answer
Favorite business book(s) you'd suggest to a founder ?
Your answer
Referred by (optional)
Your answer
Anything else we should know about you?
Your answer
How did you hear about us?
Your answer
You understand and agree to abide by Accelement's founding principals: that we encourage diversity and are welcoming to all entrepreneurs. We are business like, polite and fair to all our members and guests.
*
Yes
No
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