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About Us
All fields marked with an asterisk * are mandatory.

About Your Business Idea

Title*

Industry Categorization*

First Name*

Provide a brief summary of your company/product/idea.
Please indicate what is unique: (100 words or less)*

Last Name*

Company Name*

Job Title*

Address*

How much cash has been invested in the business to-date?*

City*

Please indicate sources of investment(s)
(check all that apply)
Owner/FounderAngels
Friends and FamilySales Revenue
Venture CapitalNone
LoansOther
Grants

State / Province

Zip*

Phone Number*

Please specify

Cell Phone Number

How much cash are you seeking at this time?

County*

Are you interested in pursuing a high-growth business strategy
which may involve raising money from outside sources, including
venture capital and other funds?
YesNoNot Sure

Email Address*

Website

Are you aware that taking outside capital will result in decreased equity
YesNoN/A

How Did You Hear About Us?

Is your company minority-owned or managed?
YesNo

Please specify

If yes, please specify Minority Group

I was asked to fill out this form by a person at

Is your company woman-owned or managed?
YesNo

Other

Including yourself, how many full-time employees work for the company?*

We only work with businesses located in one of the 21 counties of Northeast Ohio. By selecting yes, you confirm you are either currently located in Northeast Ohio or will agree to relocate here as needed.
YesNo

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