Company Name
Address
City
State
Zip Code
Telephone Number
Fax Number
URL Address
Email Address
Contact Person
Title
Name of Incubator
Date Company Was Founded
Date Company Entered Incubator
Date Company Graduated Incubator
(if applicable)
Number of Employees
Gross Revenue
Amount of Awards and Grants Received to Date
Amount of Outside Investments Received to Date
Business Categories
BioTech/Life Sciences Information Technology Technology Service Technology Transfer Other
Executive Summary: Please provide information on the following eight topics:
The problem you are trying it solve (i.e., background of your company)
Your solution (i.e., products or services, technologies, "special know-how")
Milestones achieved to date (i.e., development of technology, successful beta, customers, employee growth, revenue growth, outside investors, strategic partners, etc.)
List of awards and grants received
List of other investments and capital received
Future goals
Competition and market (including your competitive advantage)
Management team
References: Please provide three references (i.e., accountant, lawyer, customer)
1. Name:
Phone Number:
2. Name:
Phone Number:
3. Name:
Phone Number:
If you want to also apply to the 11th Annual Early Stage East Venture Fair, please check the box and we will forward this application to the Early Stage East Selection Committee in lieu of a separate application.
For further information, please contact Loury Davis at 410-332-8838 or at ldavis@saul.com .
