Incubator Application
Thank you for your interest in the SEG Incubator. We look forward to learning about your ideas!
If you have any questions,
please reach out to us at
info@segreenhouse.org
.
2020 Dates:
Meeting Dates and Times:
Mondays and Wednesdays, 5:30 pm - 7:30 pm
Program Duration:
Monday, November 2 - Wednesday, December 9
First Name:
Last Name:
What are your pronouns?
He, His, Him
She, Her, Hers
They, Them, Theirs
Other
Other Pronouns
Job Title:
Address:
Please provide a mailing address in case we need to send you course materials.
City/Town:
State:
Zip Code:
Email Address:
Phone Number:
Venture Questions
Name of venture
If no name,
please
answer
N/A.
If your venture has a website please enter the link here:
Please list your venture's social media links here:
Please describe your venture idea:
300
characters
or less.
What/Who motivated you to start your own venture?
Please explain the need for this type of venture:
Why would you like to participate in the SEG Incubator?
Are you participating as an individual or as part of a team?
Individual
Team
Please list the full names and email addresses of all additional team members:
What is the current stage of development of your venture?
Ideation (no revenue, business or organization is an idea, not yet in operation)
Start-up (some revenue, refining business model)
Established (solidified business model, scaling, expanding)
What types of support do you need to make your venture successful?
Access to a knowledgeable network
Mentorship from experts
Access to potential funders and investors
Peer support from a community of entrepreneurs
Credibility as an entrepreneur
Other:
Venture support other:
Does your venture fall into any of the industry clusters listed below?
Aging and Longevity
Design
Education
Environment
Food/Nutrition
Health and Wellness
Technology
Workforce Development
Venture doesn't fall into any of the above
Does your venture fit any of the following features?
Age 55 and over owned or led
Formerly incarcerated owned or led
Immigrant/refugee owned or led
LGBTQIA+ owned or led
Person of color owned or led
Person with a disability owned or led
Student owned or led
Veteran owned or led
Woman owned or led
None of the above
Other
We track this information because these leaders have historically had less access to capital and resources and it is part of our mission
to change that.
Other Features
Individual Questions
To which gender group(s) do you most identify?
Female
Male
Nonbinary
Prefer not to say
Other:
Other Gender Group
To which ethnic/racial group(s) do you most identify?
African-American/Black
Asian
Caucasian (non-Hispanic)
Latino/a or Hispanic
Middle Eastern or North African
Native American or Aleut
Native Hawaiian or other Pacific Islander
Prefer not to say
Other:
Other ethnic/racial group
Are you the leader/owner of the venture?
Yes
No
What is the ethnicity/race of the venture's leader/owner?
African-American/Black
Asian
Caucasian (non-Hispanic)
Latino/a or Hispanic
Middle Eastern or North African
Native American or Aleut
Native Hawaiian or other Pacific Islander
Prefer not to say
Other:
We track this information because some leaders have historically had less access to capital and resources because of their race/ethnicity and it is part of our mission to change that.
Leader/owner ethnicity/race other:
How did you hear about us?
Please select...
Press
SEG Employee Referral
SEG Event
Social Media
Web
Word of Mouth
Other
Name of SEG Employee
Other way to hear about us
reCAPTCHA helps prevent automated form spam.
The submit button will be disabled until you complete the CAPTCHA.
Contact Information