Companies Application Form
CiMed connects Israeli Medical Technology companies to the Silicon Valley health and Medical technology ecosystem.

Application Deadline: March 21, 2016
Delegation Date: June 21-24, 2016

Company Name: *
Your answer
Company website URL *
Your answer
Year founded: *
Your answer
Founders names: *
Your answer
Number of full time employees: *
Your answer
Office locations: *
(city, state)
Your answer
Contact person full name: *
Your answer
Contact person email address: *
Your answer
Contact person phone number: *
Your answer
Category: *
Required
Who are your customers? *
Required
Describe the company's regulatory status:
(exm. Clinical trials stage, FDA Approved...)
Your answer
In which phase of product development are you?
Are you Pre or Post revenue?
How is your product innovative in its market?
Your answer
Demo URL:
Your answer
Funds raised to date: *
Source of funding: *
Required
Name your investors: *
Your answer
Your digital footprint:
Provide any links for founders Twitter, Linkedin, facebook, etc. accounts
Your answer
How would you like to benefit from participating in the delegation?
Delegation members are eligible for a full program from June 21-24, 2016 that includes visiting hospitals, clinics, corporates and meeting sessions with executives, VIP receptions, Fireside chats during the summit, prescheduled meetings, mentorship program and more.
Your answer
How did you hear about CiMED? Did someone refer you to this summit? If yes, could you please name the person who referred you?
Your answer
Is there anything else you would like to add to your application?
Your answer
CiMED provides several ways for startups to get visibility on-stage. Select one of the following choices that best suits your company: *
Application Information
APPLICATION IS FREE.

Participation cost is due after participation has been confirmed.

Participation fee for CICC members: $1,950
Participation fee for non CICC members: $2,250

Participation fee includes all three conferences (CICC, UCSF, WSGR) and year-long CICC membership.

- Application Deadline: March 21, 2016
- Notification of acceptance: April 1, 2016
- Participation Fee Due: April 5, 2016

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