Collaborative Capital Raising Program for Women Entrepreneurs - Intake Form
We look forward to learning more about you, and your funding needs. Please take 5 minutes to complete this simple form.
Email address *
Company Name *
Your answer
Contact Name *
Your answer
Email *
Your answer
Your answer
Twitter Account
Your answer
LinkedIn Profile Link
Your answer
Which program are you interested in? *
Status of Capital Raising *
Which funding sources do you want to access? *
Funding Goal (How much money are you seeking?) *
Your answer
Industry Type
Which of the following resources have you accessed?
Which resources are you interested in learning more about?
Do you currently have a lawyer?
If you have a lawyer, what firm is your lawyer from?
Your answer
Do you currently have an accountant?
If you have an accountant, who or which firm?
Your answer
Do you currently have a mentor/advisor?
Are you currently or were you previously a member of an accelerator or incubator?
If you have been a member of an accelerator or incubator, which one?
Your answer
What is your experience level with raising capital?
Just getting started
Done this before, raring to go!
What is your comfort level with raising capital?
Let's do this!
Are you comfortable leveraging your own networks to share your story?
It makes me uncomfortable
Are you currently engaging with investors?
If yes, do you have any commitments?
Your answer
What is the problem that you are trying to solve with your business?
Your answer
What is the impact that you want to have on the world?
Your answer
What is your timeline for raising the capital you need?
Your answer
What other resources do you need?
Your answer
What does success look like for you?
Your answer
Note: A limited number of subsides are available to assist with program fees. Do you require a subsidy to move forward with this program?
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