Applicant Name / Function / email & phone/ Affiliation code
First name *
Your answer
Last name *
Your answer
Email *
Your answer
Phone *
Your answer
Function *
Your answer
Affiliation code
Your answer
Company Description
Describe your activity and your product(s) – 500 characters *
Your answer
Stage of development *
Your answer
Short team description – 500 characters *
Your answer
Please describe any already existing regulatory approvals like FDA or CE Mark. *
Your answer
Clinical needs
Your answer
IP
Your answer
Executive Summary
Competitive Situation – 1000 characters *
Your answer
Business model, target customers / stakeholders and geographic expansion – 1000 characters *
Your answer
Actual Market position – 500 characters *
Your answer
Short summary of internationalization needs and strategy – 300 characters *
Your answer
Company Revenue (not mandatory) *
Your answer
Financing stage and next milestones
Acquired Financing - Briefly describe the amount of funding you have acquired and the manner of funding + the stage of fundraising (ie bootstrapped, angel, VC). *
Your answer
Financing Required - Briefly describe the financing amount you seek in your next round(s). *
Your answer
Actual market cap if listed ? *
Your answer
Where do you forsee your company in 3 years? Thinking about being listed? *