CIM@MATTER Venture Application Form
Primary Contact
First Name
Last Name
Title
Email
Phone
Company Information
Company
Website
Company Description
Phase of Development Status
Please select...
Market Assessment
Product Design and Build
Market Validation
Customer Acquisition
Scaling
Three Key Milestones You've Achieved
What would you hope to accomplish during the 6-month program and how could we help?
What mentor skill sets would be best suited to address the needs of your venture?
Team
When was the company founded?
Are you working on this full-time?
Please select...
Yes
No
What led you to start the company?
What makes your team the best?
Number of Full-Time Employees
Number of Contractors
Market Opportunity
Healthcare Problem Your Company Solves
Who is or will be purchasing your product?
Please select...
Payer
Provider
Supplier
Manufacturer
Other
Who is the primary end-user of your product?
How large is the market for your product?
Technology
Type of Product Company Provides
Please select...
Service
Technology
Innovation Category
Please select...
Healthcare IT
Medical Device
Biopharmaceutical
Medical Diagnostic
Other
Do you have intellectual property protection for your technology?
Business
Company's Incorporation Form
Please select...
LLC
C Corp
S Corp
Not Incorporated
Have you raised funding?
Please select...
Yes
No
Funding Type
Venture Capital
Angel Investors
Family and Friends
Grants (STTR)
Grants (SBIR)
Other
Cash Invested to Date
If relevant, briefly describe your regulatory reimbursement strategy.
What is your exit strategy?
Membership at MATTER
Primary Goals During Time at MATTER
Access to Strategic Partners
Refine Revenue Model
Find Investors
Access to Mentor Network
Acquire Customers
Develop Go-to-Market Strategy
Further Product Development
Just Need Office Space
Other
Top Challenges
Financing
Sales
Coaching / Mentoring
Business Education
Marketing / PR Support
Talent Recruitment
MATTER Community Contribution
Desired Program Start Date
How did you hear about CIM@MATTER?
Please select...
Friend
MATTER Member
News Article
Social Media
Search Engine
Other
Do you have any questions for MATTER?
Upload your business plan or executive summary here.
We would appreciate seeing your elevator pitch. Please record a 1-minute pitch, upload to YouTube or Vimeo and share the link with us below.
If you do not wish for your video to be visible to those without the URL, you should be able to make it non-public or unlisted, but please do not password protect your video.
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