NorthStar - Intake Form
This intake form will be used by NorthStar to ascertain the entry point to our Programs. It is acceptable to leave non relevant fields blank as it helps us understand your company profile.
Email address *
Company Name
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Contact name
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Phone number
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Link to AngelList Profile:
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Existing company
Years in business:
Your answer
Number of Key Co-Founders
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Revenue Stage
Size: #employees
Venture raised
Your answer
Venture required
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Company Stage
Token Generation event details (ICO/STO) date/amount/location
Your answer
Blockchain Stage
Why Blockchain?
Rate the value of Blockchain characteristics a they apply to your model (1 is low)
Supply chain
Financial Transactions /settlements
Data management (CRM, ERP, DB etc.)
Data integrity
KYC / User ID security and validation
Regulatory compliance
Global operations
Inter-org data management (Distr ledger)
Automated governance
Value standard / token
Rules /Decision Engine
Business intelligence
Add detail if you entered Other above
Your answer
External motivation to adopt Blockchain
If you answered Other above please provide details.
Your answer
Section A: If you have Blockchain technology expertise on staff - tell us more
from your perspective what is the blockchain and its impact on your business
Your answer
Section B: Business Details
Complete this section if you have an existing business
Business Overview (Briefly describe your venture)
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Product/Service Overview (Briefly describe how your product or service works)
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Describe a single customer and how they will use your product or service. What is the value proposition for this specific customer?
Your answer
Do you have a working prototype? Can you show it? If not, how long will it take you to produce one? Explain what the prototype or product demonstrates.
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How do you sell to your customer?
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Why will your customer buy your product or service instead of your competitor's?
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What is the long-term vision of your company? How is your product going to change the world?
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How do you plan to protect your idea from competitors and imitators?
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What is the single most important dimension on which your technology outperforms your competition?
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How do you think BlockTech Ventures can help your venture succeed?
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Section C: If you have some Blockchain documented and/or developed - tell us more.
If you check boxes above and/or Other and would like to expand on your Blockchain build to date please fill us in
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