Strategy Accelerator Intake form
All information gathered in this form is used for Accelerator Facilitators and Coaches, and also for reporting purposes for Doyenne funders. we do not release any information to 3rd party entities or with other organizations
All information gathered in this form is used for Accelerator Facilitators and Coaches, and also for reporting purposes for Doyenne funders, we do not not release any information to 3rd party entities or with other organizations
CONTACT INFORMATION-Accelerator Attendee Name (registration is for 1 female founder) *
What is your venture name? *
Principle office address? *
Mailing Address (write “Same” if same as Principle office address)
Preferred Email? *
Preferred Phone number? *
Website URL for Venture(may be social media page if no website created)
Title within Venture? *
VENTURE INFORMATION- Does your venture meet the following criteria? Mark all applicable items: *
Please indicate your business entity type: *
What industry does your venture primarily serve? *
What year did venture start?
How much revenue did your venture generate in the last fiscal year?
Did you generate profit in your last fiscal year?
What problem and/or opportunity does your venture address?
Why should customers/clients use your venture instead of your competitors?
How many co-founders are within the venture?(Do not include applicant in answer)
If you have co-founders, what type of founder agreement do you have in place? *
Is the applicant for the Strategy Accelerator the primary shareholder of the company?
How many full time and part-time employees does your venture currently have?
How many Contractors does your venture currently pay?
Do you have interns within your venture?
Who is your venture’s target audience?
APPLICANT INFORMATION - AGE?
Gender?
Pronouns?
Ethnicity?
Identifies as…
Time Commitment within venture
Salary
STRATEGY ACCELERATOR GOALS- What goal(s) do you hope to achieve by the end of the Strategy Accelerator Program?
What is the most pressing area of expertise you currently need access to for moving your venture forward?
If other, please specify:
What are some areas of expertise you do not currently need to access to?
If other, please specify: