Startup Registration Form
Company Overview
Company Name *
Company Owners *
Company Ownership Structure
Contact Details
Address *
State *
Choose a state or select 'Overseas'
Country *
Phone Number *
Email Adrress *
Social Media *
Website, Twitter, Facebook, or/and Instagram. Please indicate.
Business Details
What is your product or software or solution brand name? *
Give a brief description of your product / services *
What business issues or socio-economic problem is this product / service solving? *
What are the unique values / features of your products or solution? *
Please upload your product brochure or video here
Who are your target markets? *
Who are the major players in the space and what is your competitive advantage? *
How old is your company?
What is your average annual turnover in the last 1- 3 years?
How many people started the company? *
How many employees do you have currently? *
Have you registered a patent of the product/service/solution? *
If yes, when & where did you register it?
Is your company in early start-up or revenue stage? *
Is your product fully developed or still in alpha / beta stage? *
Does your company have a fully developed business plan? *
Is the product / service infringing on any other intellectual property? *
Has the company received any outside funding since incorporation? *
If your business is adequately funded as indicated, how many employment opportunities / jobs can you create?
If your company is new, how will you make money from this product?
What is the size of funding required to take your business to the next level?
How much revenue do you foresee you can realize in the next five years?
Is this the first time you are hearing about the Office for ICT Innovation and Entrepreneurship? *
How did you hear about us? *
Before submitting this form, please not that you certify that: (a) the information included in this application is true, accurate, current and complete; and (b) you have the right to provide it and for it to be used for its intended purpose and that it does not infringe the rights of any third party, including without limitation, any third party's intellectual property rights, data privacy or confidentiality rights.
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