ADVANCE SOCIAL INNOVATION STARTUPS INCLUSION PROGRAM PRE-SELECTION ASSESSMENT FORM
Advance Social Innovation has developed a program called "Startups Inclusion Program" to provide resources and opportunities for women and minority entrepreneurs. The goal of the program is to help underrepresented entrepreneurs to showcase potential of their startups to investors or on Crowdfunding sites to raise capital.
All Information provided by startups will be for our internal purposes only. We do not share your information with investors without your consent.
Advance Social Innovation
Name of the Startup or Social Enterprise *
In which of industry your enterprise operates ? *
Required
What kind of help you need to scale your startup or social enterprise? *
What is the current stage of development of your startup or enterprise? *
Required
Fundraising stage *
Required
When was your startup or social enterprise created? *
MM
/
DD
/
YYYY
Linkedin Profile of the Enterprise
Startup or Social enterprise Website *
Social media profiles (Twitter, Pinterest etc.)
City, Zip code/ Postal code *
What legal form is your startup or enterprise? *
Name and Email address/s of founder/s? *
Phone number?
Why did you start your startup or social enterprise? *
What is the population you aspire to create benefits for that is not currently being served? Who else will benefit? *
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