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Stasion Startup Member Registration
This registration form will be used for helping Stasion and INBIS to identify which startups are met with our qualifications to join with INBIS incubation programs.
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* Indicates required question
Name
*
Your full name as startup owner
Your answer
Email
*
Your answer
Twitter account:
i.e. @stasionmalang
Your answer
Twitter account:
i.e. @stasionmalang
Your answer
Contact No.
*
Office or Home Phone
Your answer
Mobile No.
Your Mobile Number
Your answer
Address
*
Your home address
Your answer
Startup Name
*
Your startup business name
Your answer
Startup URL
*
Your startup URL
Your answer
Startup-Short Brieft
*
Describe what your startup business do.
Your answer
Vision and Mission
*
Describe your vision and mission for your Startup
Your answer
Founder
*
Your answer
Co-Founder #1
If any
Your answer
Co-Founder #2
If any
Your answer
CEO
*
Your answer
CTO
Your answer
Startup Category
*
What is your startup's track?
Choose
Social Networking
E-Commerce
Game
User Generated Content
Portal
WAP
Mobile Apps
Aggregator
News
Forum
Social Media
Directory
Marketplace
Shipping/Courier
Other
Industries
*
What is your industry fields?
Biotech
Game
Cleantech
Computing
Education
Entertainment
Financial
Food and Drink
Gaming
Health
Information Technology
Internet
Lifestyle
Media
Mobile
Nanotech
Real Estate
Retail
Sports
Travel
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