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Startup Intake Form
Please tell us about you and your company. And don't worry - we'll treat and keep your data confidential as if it's our own.
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* Indicates required question
What's the name of your company?
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Your answer
Which country is your company incorporated in?
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Please type "N/A" if it's not yet incorporated.
Your answer
Do you have a website?
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E.g.,
https://www.541ventures.com
/ type "No" if you currently don't have one.
Your answer
What's your first name?
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Your answer
And the last name?
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Your answer
What's your work email?
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Your answer
What's your title in your company?
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Your answer
How did you find 541 Ventures?
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Web Search
I've met your team.
We have a mutual friend.
Other:
If you've met us or have a mutual friend, who was it again?
Your answer
Which stage of financing are you currently raising?
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Pre-seed
Seed
Series A (incl. Pre-Series A)
Series B+
How much are you raising?
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In USD, please. E.g., $1,000,000
Your answer
At what valuation are you raising the current round?
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In USD, please (e.g., $5,000,000). Please type "N/A" if you haven't determined the valuation yet.
Your answer
What's the current valuation from the most recent round?
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In USD, please. Please type "N/A" if this is your first raise.
Your answer
How much have you raised in the previous rounds?
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In USD, please. E.g., $1,000,000. Type "None" if this is your first raise.
Your answer
Are you B2B or B2C?
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B2B
B2C
Both
Other:
Which of the following verticals are you in?
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Enterprise Software
Entreprise Hardware
Computing Hardware (e.g., chips, sensors, etc)
Energy Solutions and Infrastructure
Healthcare (incl. Bio, Medical Devices, SaMD, etc)
Human-Device Interactions (Human-Device Interfaces)
Cybersecurity
Consumer Software or Consumer Internet
Artificial Intelligence and Artificial Intelligence Infrastructure
Data (incl. Big Data) Management and Enablement
Other:
Required
Your Pitch Deck URL
*
PDF only, please, as we'll not view any other format. Please make sure it's downloadable. Collecting email is fine.
Your answer
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