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Madworks Fall 2019 Cohort
Please fill out this form. If you have any questions - contact Collin at
support@madworksaccelerator.org
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Company Name
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Company Address
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City
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State
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Zip
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Main Contact Phone Number
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Please provide a contact number that has little likelihood of changing. In case Madworks needs to get in contact with you after the Cohort is finished - specifically for WEDC required reporting.
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Main Contact E-Mail
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Please provide an e-mail address that has little likelihood of changing. In case Madworks needs to get in contact with you after the Cohort is finished - specifically for WEDC required reporting. (Might be best to use a personal e-mail!)
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First Founder Name
*
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First Founder E-Mail
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Second Founder Name
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Second Founder E-Mail
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Third Founder Name
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Third Founder E-Mail
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EIN Number (Tax ID)
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