weMultiply Initial Intake Application

VENTURE APPLICATION FORM

Please answer each question below and click "Submit Form" at the bottom. Your responses will be reviewed and responded to within 72 hours for feedback.


Company Name	*
Owner(s) Names and titles	*
Contact email	*
Contact phone
Preferred method of contact
Legal Structure (select one)	*
How did you hear about weMu (please specify below)
Please specify

Answer each question below with as much detail as is necessary:

What problem in Healthcare does your business or innovation solve?	*
What is your one-line elevator pitch?	*
What is the target market for your product and how big is that market?	*
What is your customer acquisition mode? How will you attract or acquire your target users?	*
Who are your competitors?	*
What is your competitive advantage compared with your competitors?	*
Identify your key team and advisor members. What are their skillsets?
What are your fund raise terms? How is it structured and what will you use the funds for?
What is your current investment to date? What kind of contributions have funded your venture so far?
What additional resources (non-capital) are you seeking that will help build your business?	*
Have you applied or been through any business accelerator programs before? If so which ones?	*
What current clients, partnerships do you currently have?
Are there any patents?	*	If so please describe
What keeps you up at night?	*


DISCLAIMER: This submission, its results and any other documentation contained in this site is for information purposes only. As such, all representations, statements, or other information contained here is non-binding and does not create any obligation, promise or otherwise on any person or entity. All information and data gathered herein shall belong to weMultiply. No promises or obligations are made relating to any statements contained here and response time may vary based on the information provided with the form and its applicability and fit with the overall mission and objectives of weMultiply.