Formulaire d'inscription
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A. Product
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1. Description
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Name of the product
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Originality of the product
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Key objective of the company
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Your domain of activity is based on (maximum 3 replies)
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other? please specify
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Your group target is located among activities based on
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other? please specify
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Today, your main customer is in the area of (maximum 1 reply)
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other? please specify
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2. Initiator of the product
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Name
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First Name
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3. Founder of the company
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Name
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First Name
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4. Co-founder
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Name
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First Name
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B. Company
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1. Description
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Name of the company
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Legal status
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other? please specify
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Year company was founded
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or anticipated in
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Head office
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Street
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Code number
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City
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Country
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E-mail address
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Web
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Mobile
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Skype
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Twitter
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Facebook
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Linkedin
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2. Forecast
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Domain in which the product/service is used
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other? please specify
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Did you receive any financial support ?
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if yes, type of support
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other? please specify
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C. Human Ressources
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full time staff
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part time staff
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subcontracting
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volunteers
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other? please specify
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Manpower in persons/year
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D. Finance
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Capital
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Founder's contributions in %
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Associates in %
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Family in %
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Venture capital in %
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Business Angels in %
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Public contributions in %
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Other contributions in %
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Turnover estimate for the next 12 months
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Annual turnover anticipated in 3 years
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Actual priorities for success/needs in
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other? please specify
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Name of present partners
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Additional documents
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Please provide your business plan (market situation, objectives, définition of the project, products, marketing concept, planning, key success factors, 3 year budget). Allowed type is .pdf, .doc, docx or .zip. Max size allowed : 3mb.
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Questionnaire completed by
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Name
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First name
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Email
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Comments
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