Venture135 Event Application Form
Email *
Name of the person filling this application form *
Email of the person filling this application form
 *
Full legal name of the company
 *
Company website
 *

Which year was the company founded? 

 *

Where is the company headquartered (state and country)?

*

Please provide a one-sentence description of what your company does?

 *

Which industry are you most closely aligned with?

*

What stage is your company currently raising or about to raise?

 *

How much total capital have you raised so far including current and previous rounds (in USD millions)?

 *

If you have raised capital, when did you close your last round?

 *
MM
/
DD
/
YYYY

What was the valuation of your last round or cap if a convertible note (in USD millions)?

 *

If you are fundraising, how much are you fundraising (in USD millions)? If you are not in the market for fundraising, please answer "0".

 *

How much revenue are you generating per month (in USD)?

 *

What percentage of your last monthly revenue was recurring (in %)?

 *

What is your last monthly burn rate (in USD)?

 *

Do you or one of your co-founders can be identified as  Traditionally Under-represented Founders (TURF)?

 *

Are you or one of your co-founders a veteran?

 *

Do you or one of your co-founders identify as female? 

 *

Are you or one of your co-founders of Hispanic, Latino, or of Spanish origin?

 *

How would you describe yourself and your co-founders? Check all that apply.

 *
Required
Who within your company would be presenting at this pitch opportunity? Please provide the name.
 *
Please provide link of your Pitch deck.
How did you get to know about this event? *
If you get to know about this event from " Referral", then please name it. *
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Packard Place.

Does this form look suspicious? Report

Google Forms