Application form
Applications are due no later than 5:00 pm, Ukraine time, on October 8, 2019.
Applications received after that time will not be considered for the next incubation period.

Our application is designed to help us better understand you and your team, your market, your progress so far, and your idea. Please take time to fill it out as best as you can. Your goal is to demonstrate your ability to execute on the idea you are pursuing.

We want our founders to be passionate about their startups. We want our mentors to be passionate about the companies in each Incubator class. With passion, we believe anything can happen. Show us how passionate you are about your team and your product.

All responses and all written or recorded materials should be in English.


Name of business: *
Your answer
Name of principal contact (to whom all communications will be sent): *
Your answer
Email address of principal contact: *
Your answer
Phone number of principal contact: *
Your answer
Current business address (if applicable): *
Your answer
Which Incubator campus are you interested in joining? (Select one.) (Note that each business must attend lectures and videoconferences only at the Incubator campus to which it has been assigned, unless approved by the Incubator manager in writing.) *
What stage of development is your business? (Check all that apply.) *
Required
Have you, any of your teammates, or your business been in an incubator or accelerator before? *
If “Yes,” list the incubators/accelerators:
Your answer
Description of business/product: (1,500 characters or less)
Your answer
How do customers use or interact with your product? (Check all that apply.) *
Required
What problem does your business/product solve? (1,500 characters or less) *
Your answer
What solution does your business/product provide? Why is it unique or revolutionary? What is your value proposition? (1,500 characters or less) *
Your answer
Who is your customer, what is the total size of the opportunity, and why is now the right time to go to market? Do you (or a teammate) have experience in this market or industry? (1,500 characters or less) *
Your answer
Describe your customer/user growth, if any: (Please provide any examples of traction. If your product is not yet in the market, please describe how are you tracking progress – i.e., LOIs/MOUs, waitlist sign-ups, or other indicators of early market demand.) (2,500 characters or less)
Your answer
How are you going to make money? What is your revenue model? (2,000 characters or less)
Your answer
Who are your partners (if any)? Who are your competitors? (Identify whether they are partners or competitors. List 3-5 specific names for each and the website(s) of each, if any) (3,000 characters or less) *
Your answer
Explain why you and your team will be able to successfully execute on your business and strategy. What are the unique strengths that each team member brings that will make it successful? How long have you been working together? (2,000 characters or less) *
Your answer
How many engineers and how many marketers are on your team? How much experience do they have in creating/marketing commercial products? (If none, write “none”.) (1,500 characters or less) *
Your answer
Last fiscal year revenue ₴. (State “0” if none.) *
Your answer
Current fiscal year (projected) revenue ₴. (State “0” if none.) *
Your answer
Monthly Payroll ₴ (State “0” if none.) *
Your answer
Names of all founders: *
Your answer
Names of all directors: *
Your answer
Names and titles of all officers: *
Your answer
Number of current employees (full-time and part-time, not including officers): (State “0” if none.) *
Your answer
Business owned by: (Select one.) *
Ownership information (Name, title, email address, phone number and percentage owned for all owners): *
Your answer
Do you have a patent on any of the intellectual property related to your business? *
If “Yes,” please describe the applicable patent(s):
Your answer
If “No,” please describe whether you plan to apply for a patent, or if not, why not:
Your answer
Describe any other protection of the intellectual property related to your business: (If none, write “none.”) *
Your answer
Date company/business was established; what organizational structure (limited liability company, etc.); and where organized. (If none, write “none.”) *
Your answer
Social media: (Please include links to all social media sites relating to the business, including Twitter, Facebook, Instagram, and LinkedIn. If none, write “none.”) *
Your answer
Website: (If none, write “none.”) *
Your answer
Mobile apps: (Paste the URL of your app’s page(s). If none, write “none.”) *
Your answer
Why do you want to join this Incubator? Why do you want to work with us? (1,500 characters or less) *
Your answer
Were you referred to us by someone? If so, please let us know who. (1,000 characters or less) *
Your answer
Are you working on this business full-time with no other work/freelance or other obligations? If accepted into the Incubator program, do all founders commit to fully participate in the program? (1,500 characters or less) (Note that 100% attendance at all Incubator functions is mandatory, unless the Incubator manager approves an absence in writing. Some Incubator events occur all-day on Friday and Saturday. The failure of any founder to fully participate, without prior Incubator manager approval in writing, may result in the expulsion of your business from the Incubator.) *
Your answer
Slide presentation – You may add a link to a Google presentation, but none is required. If you do add a link to a presentation, it can be no more than 7 pages, each page being no more than 1,000 characters each.
Your answer
Videos – You may link to 2 videos below, but none is required. Show how your product or prototype works in 1 minute or less. Introduce your team in 1 minute or less.(Use a public YouTube/Vimeo URL only (ex. www.youtube.com/foo). Do not password protect your video but non-public/unlisted is OK.)
Your answer
Date *
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