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APPLICATION FOR COMPANY STAGE
Your Startup Name *
Your Startup Website/Social Network Link *
Is Your Business Registered? *
Select Answer
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Business Ownership
Select Business ownership
Sole Proprietorship
Partnership
Company Limited by Shares
Number of Employees (excluding Yourself)
Postal Address*
Street Name *
Apartment/Building Number *
Ward/Province/State *
District Name *
Current Business Address and Location *
Country Name *
Phone Number*
Email Address *
How did you learn about this Programmer? *
Select How did you learn about this Program
Internet
Social Media (Television, Radio and Newspaper)
Friends/Colleagues
DTBi Website
COSTECH Program
Start-up Event
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DTBi Staff/Post-Employee
In which industry category does your Business idea best fit? (Pic one)
Select Category
Agribusiness
Manufacturing
Tourism
Insurance
Energy
Healthy
Other
Product information *
What does your company do?
What is your product/service and how does it work? What problem is your product/service solving?
Who is your target customer?
What is your business model? Be specific, indicate your primary revenue streams and your distribution channels
Differentiation (What is unique and/or innovative with your business?)
Who are your primary direct and indirect competitors as you view them? How do you differentiate yourself from your competitors?
Traction and financials: Please describe the traction of your company has reached. Include the number of customer and/or users, market feedback, any pilots you have conducted, partnerships etc
Is your company pre or post revenue? Has it made any money? (Please explain)
Describe your fundraising. Include the type of capital (equity, loans, grants, awards), amount, reception month and year. What are your fundraising objectives in the future? How much are you seeking to raise?
Describe your targeted market and its associated characteristics. Include age, gender, career and life style in less than 200 words
Describe your exit strategy: How will you generate returns on capital for outside investors? Scale and impact
Describe your company’s national and international strategy and/or plans for expansion into new markets. Include any specific milestones or a broad overview
Describe your impact. If your company is successful, how will the world be different? Please include metrics you are using to measure your impact.
Team (Why are you thing you have a winning team?)
How is the spread of COVID-19 affecting your business? How is your team responding to mitigate the overreaching impacts of the pandemic to your business?
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