Ideator Application
The SEG Ideator
is a
n 8 week program designed to help you develop, test, and vet your ideas in a risk-free and supportive environment.
If you have any questions,
please email Austin Wilson at
awilson@segreenhouse.org
.
First Name:
Last Name:
What are your pronouns?
He, Him, His
She, Her, Hers
They, Them, Their
My pronouns are not listed above.
My pronouns are:
Job Title:
Mailing Address:
Please provide a mailing address in case we need to send you course materials.
x
City/Town:
State/Province:
Please select...
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Zip Code:
Email Address:
Phone Number:
Are you over age 18?
Yes
No
Venture Questions
Name of venture:
(If your venture doesn't have a name yet, please write your name here).
If no name,
please
answer
N/A.
x
Please describe your venture idea:
300
characters
or less.
x
If your venture has a website please enter the link here:
Please list your venture's social media links here:
Are you participating as an individual or as a team?
Individual
Team
Please list the full names and email addresses of your team members:
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
Is your venture owned or led by a person who identifies with any of the following qualities?
Age 55 and over
BIPOC (Black, Indigenous, People of Color)
Formerly incarcerated
Has a disability
Immigrant/Refugee
LGBTQIA+
Student
Veteran
Woman
None of the above
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)
Are you seeking a workspace?
Yes
No
Venture Questions
Please describe the product/service you are interested in developing:
Why do you think it's a good idea? Why is your idea important? How will it be helpful?
What steps have you taken to explore the success or need for this idea?
Who/what inspired you to take this idea on?
Why would you like to participate in the SEG Ideator?
Individual Questions
To which gender group(s) do you most identify?
Female
Male
Nonbinary
Prefer not to Say
My gender group is not listed above.
My gender group is:
To which ethnic/racial group(s) do you most identify?
Asian
Black or African American
Hispanic or Latino/a/x
Indigenous Peoples, First Nations, Native American, or Alaska Native
Middle Eastern or North African
Native Hawaiian or other Pacific Islander
White or Caucasian
Prefer not to say
My ethnic/racial group is not listed above.
My ethnic/racial group is:
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
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Contact Information