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Small Business Programming Application

Applicant Info

First Name

Last Name

Email Address

Phone

How did you learn about Bounce?

Company Contact Info

Company Name

Company Website

Current Business Address

Apartment, suite, etc

City

State/Province

ZIP / Postal Code

Country

Company Overview

Brief description of your company and its products/services:

How long have you been in business?

What problem are you solving?

How did you find out the problem exists/What is your market-based evidence of the problem you are solving?

What is unique about your product/service?

What is your vision for the company in the next 5-10 years?

Are you seeking physical office/lab space?YesNo

Please provide an estimate of your requirements for physical office/lab space

Company Demographics

Founders and Key Team MembersPlease provide the names and roles of any co-founders or key team members, as well as information on their background/expertise and equity ownership

Have you raised any capital?If yes, please provide details (amount, source, valuation)

What are your current business needs?E.g. funding, mentorship, partnerships

What do you hope to achieve by participating in Bounce's Entrepreneurial Support Programming?

Please share any additional information that you believe will help us better understand your company and its needs.

Personal Demographic Information (Optional)Please note that providing personal demographic information is entirely optional and will not impact the evaluation of your application. This information is collected to help Bounce better understand the diversity of its applicants and to promote inclusivity in its programs.

Age

Gender

Race/Ethnicity

AsianBlack/AAHispanic/LatinxMiddle Eastern/North AfricanNative/Indigenous AmericanPacific IslanderWhite/CaucasianOption not listedPrefer not to specify

Select All That Apply

Do you identify as part of the LGBTQ+ community?

Military Status

Highest level of education

Household SizeSelect how many people you live with including yourself. If you live alone, select “1”

Annual Household IncomeTotal household income before taxes during the past 12 months, in estimate.

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