Apply to be a Mentee
Welcome
Welcome to the application process. Leveraging the wisdom and insight of the Ben Franklin and PACT communities for the progress of their entrepreneurs, Mentor Connect brings the experience of a curated team of leaders and experts to the high-potential entrepreneurs most ready to grow, assisting development of the business skills they need to bring ideas and inventions to market.

In collaboration with PACT and Ben Franklin Technology Partners, Mentor Connect is modeled after the MIT Venture Mentoring Service. As a free and confidential program, Mentor Connect partners entrepreneurs with expert mentors in the region to help grow business. It provides entrepreneurs with coaching, connections and the tools to build a successful roadmap for emerging growth.

You have been chosen as a Mentee for this prestigious program. Please provide answers for each of the required questions so we can best match you with a mentor. The information you submit will be shared only with parties relevant to the Mentor Connect program.

If you have any questions, please contact Jennifer Cohen at jcohen@philadelphiapact.com.

Company Name *
Your answer
Address *
Your answer
Name *
Your answer
Title *
Your answer
Office
Your answer
Email *
Your answer
Mobile *
Your answer
PACT and/or Ben Franklin Affiliation *
Website
Your answer
Please select the industry and category that describes your company best.
Technology
Healthcare
Other
Stage of Company
Have you formed as a legal business entity? *
Are you solely focused on this company? If not, what else are you focused on? *
Please describe what else you are working on, if applicable.
Your answer
How were you referred to Mentor Connect? *
Preferred Communication *
Required
Please provide more information about your company.
Describe your business. Please give your elevator pitch. *
Your answer
What is the problem that you solve? *
Your answer
Who are you target customers? *
Your answer
What are your products and/or services? *
Your answer
What is your business model? *
Your answer
Do you have secret sauce, and/or IP? *
Your answer
What is your current status in regards to product development, fundraising, and revenue? *
Your answer
What type(s) of Mentor Connect help do you think your start-up needs? *
Required
What are your criteria for success? *
Your answer
What gaps in your company growth can Mentor Connect help fill? *
Your answer
What do you want to accomplish as a result of you working with Mentor Connect? *
Your answer
Any additional comments?
Your answer
Thank you very much for taking the time to complete this form. We will be in touch with you soon.
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