Startup Request Form

First name

Last name

E-mail

Phone

LinkedIn Profile

Short bio

Country of Residence

Position/Title

Startup Name

Startup Website

Other Startup URLs (social media, press, etc.)

What industry does your startup belong to?

Short description of your startup (100-150 words)

Annual recurring revenue of your startup ($)

Amount of funds raised by now

Next funding round amount (The Ask)

Does your team include a female co-founder or manager?

Yes

No

Please select your age range:

How many employees does your company currently have?

1 (Solo founder)

2–5

6–10

11–20

I agree that the data provided will be processed by XY Incubator SRL (XY Partners)

TechVillage Startup Registration