PortXL Antwerp 2019 Application Form
Thank you for showing interest in PortXL Antwerp. Kindly fill in this form and we will get back to you as part of our scouting process.
Company Name *
Goals *
Company Website
Company LinkedIn
Company Facebook
Country *
Founding Year *
PortXL Sectors *
What Stage is your company at? *
Describe your product/solution *
Market Situation *
Competitive Advantage *
Attachments (Optional - You may include a PDF which introduces your company/product)
Founders *
Team *
Are you in other start-up programs?
If you answered Yes to the above question, please elaborate
Funding raised *
Equity Breakdown *
Monthly Revenue *
Monthly Expenses *
Future Funding *
Point of Contact *
Contact Number *
Contact E-Mail *
Contact Skype *
How did you hear about PortXL? *
Availability *
Never submit passwords through Google Forms.
This form was created inside of PortXL. - Terms of Service