Tell us about yourself!

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Thank you for your interest in Cintrifuse and giving your time to complete this form! 

We understand it is quite detailed so we appreciate the investment of your time as it will help us best serve you. It will take about 15 minutes to complete. 

All financial and growth information is CONFIDENTIAL. 

Quick reminder: Cintrifuse's member base applies to technology (i.e. software) or technology-enabled (i.e. IP protected products/processes) startups. If you are interested in becoming a member, we will follow up with additional questions about your business or a request for your annual Cintrifuse membership.   

Gratefully,
The Team at Cintrifuse

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Business Information


Please approximate closest month.






What is your elevator pitch?

What is the market missing that you're providing? Why would your ideal customer (see below) buy your product/service? This will help us best represent you in discussions with investors/customers.

What is your revenue model? If your business is dependent on building a large user base, how do you plan to monetize and when? How much do you charge for your product or service?

If you had to personify your customer, what would that person look like? Example: My customer is a 40 year old male who shops at Whole Foods and reads Sports Illustrated magazine.

If we are out talking to potential customers, what type of words indicate they may be interested in purchasing or learning more about your product/service?

If you select one of these boxes, you may be eligible for opportunities from state, federal, or other institutions. PLEASE do not guess - you should know if your business qualifies!

If you select one of these boxes, you may be eligible for opportunities from state, federal, or other institutions. PLEASE do not guess - you should know if your business qualifies!



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Business Segmentation

Please select one.


To create a common taxonomy we tried to be as comprehensive as possible. We use this language to make connections in our Startup Talent, Funding Connections, and Customer Connections programs. Please select the CLOSEST that apply your business (please only resort to "other" if nothing is close). You may select more than one option.


Please select all that apply.

Who purchases your product or service? This is different than "consumer type" (see below).


Is the end consumer of your product/service a business or individual?

Which technologies are used to service your buyer/consumer? Please select all that apply.

Please select all that apply.

Additional Business Milestone Detail

Marketing/Social Media

We're asking this to stay current with your social media profiles so we can post @ you.

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Fundraising




Please list all investors including VCs and State/Federal loans/grants.

Please select the most accurate investment stage to date based on who is on your cap table. If only founders have invested, you are "bootstrap". Small dollar amounts less than $100,000 or investments from accelerators are typically "pre-seed". Small Seed rounds are a couple hundred thousand dollars; large Seed rounds can be up to a couple million. Series A rounds are several million dollars, up to mid eight figures. The progression keeps going from there. 



If you do not have a one pager, Cintrifuse will provide a template as part of the orientation process. We will ask for this to be complete before taking part in any programs. 





Please include one number, not a range.

Please select the most accurate investment stage being sought. Small dollar amounts less than $100,000 or investments from accelerators are typically "pre-seed". Small Seed rounds are a couple hundred thousand dollars; large Seed rounds can be up to a couple million. Series A rounds are several million dollars, up to mid eight figures. The progression keeps going from there.

How much cash are you spending per month? This helps us understand your urgency to raise funds.

Related to monthly burn rate, how many months do you have left until you run out of cash?
Customer/Growth Details





Who are you contractually engaged with? If investors asked us this question, what would you want us to say? Please do not include people in your pipeline (see next).

What deals or partnerships do you expect to close in the next 3 - 12 months and what will be the impact on your business? Please only include opportunities with a high degree of closing.

If you haven't had one year of revenue or are pre-revenue, please select 0%-30%

How much revenue did you generate in the last three months (doesn't need to be a calendar quarter).

Please select 0%-30% if this is your first quarter of revenue or you are pre-revenue.

Leadership Team

Cintrifuse's programs can help several members of your leadership team. As such, we would like to know their contact information, role, and level of experience to plug them in to opportunities accordingly. Add additional contacts as needed below (up to 5). Please include any team members you would like included on future communications.
Contact Detail






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We're interested in the type of rapid growth you've experienced in your professional life. We frequently include entrepreneurs in our programs/speaking events who can help others understand what it takes to grow a startup business.

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