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Sponsored Company

Registration

Company Name:
Company Website :
Sponsoring Organization:
LEVEL OF HEAVY LIFTING RECEIVED  
Sourced:
Screened:
Mentored :
Incubated:
Angel:
Address 1:
Address 2:
City State/Province:
Country:
Phone #:
Fax #:
Contact Person / Title :
Contact Person's Email:
MANAGEMENT TEAM  
1. First Name Last Name Title:
2. First Name Last Name Title:
3. First Name Last Name Title:
4. First Name Last Name Title:
5. First Name Last Name Title:
Total Number of Full Time Employees:
Total Number of Consultants/PT Employees:
Founded Date:
Legal Formation:
WEB PRESENCE  
LinkedIn Address:
Facebook Address:
Plaxo Address :
Other:
Other:
PRODUCT / MARKET CLASSIFICATION  
Is your Revenue Model based
on a Product or Service :
Category:
TARGET MARKET / USER  
Business
Consumer
Government  
CUSTOMERS/PARTNERSHIPS/RELATIONSHIPS  
Company Customer Joint Development Work 4 Hire Distribution / Promotion
Company Revenue Model
FINANCIAL HISTORY
COMPANY FUNDING HISTORY
 
  Date Rcvd Amount Rcvd Financing Method (1)
Personal/Friends&Family Funds
Academic/Research Grants
Government Contract
Work-For-Hire Project(s)
Angel(s)
Venture Capital
OTHER
% Equity Owned by Founders
(1) Financing Method (Debt, Common Stock, Preferred Stock, Convertible Preferred, Work Compensation, Other)
REVENUE HISTORY  
Pre-Revenue:
Expected Date of Revenue Generation:
P&L History Year Revenue Expenses P/L  
P&L Forecast Year Revenue Expenses P/L  
ADD DOCUMENTS - add only those documents you wish to be viewable to registered Validation Partner and Funder members of the ESM. No documents you provide will be made available to other Sponsored Companies or 3rd Party Resources
  Download Date
Executive Summary:
Powerpoint Presentation:
Financial Plan:
Business Plan:
Patent Applications:
Patent Grants (Patent #):

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