Partners Program

Please submit this form only if you have been invited by our team, and upon becoming a member of LaunchPad!

Name *

First and last name

Email *

Phone number *

Which level are you interested? *

Influencer (Corporate / University / Government)

Partner (Vendor / Industry Peer / Channel)

Required

Your Market Focus? *

Your preferred contribution format? *

Your discount to our members? % / Code? *

will post your logo along offered discounts within our preferred vendors section

Referred by? *

Agree on Program Terms *

Yes, I Agree

Required

Submit

Never submit passwords through Google Forms.

This form was created inside of OneTraction. - Terms of Service