Startup Program Interest Survey Form
Thank you for your interest in the Startup Program. Please complete this brief survey to help us understand your background, interests, and how we can best support your startup journey.
Full Name
*
First Name
Last Name
Email Address
*
example@example.com
What best describes your current role?
*
Please Select
Founder
Co-founder
Aspiring Entrepreneur
Startup Employee
Student
Other
How did you hear about the Startup Program?
Referral
Social Media
Startup Event
Search Engine
Other
How interested are you in participating in the Startup Program?
*
1
2
3
4
5
What are your main goals for joining the Startup Program?
*
Access to mentorship
Networking with other founders
Product development support
Funding opportunities
Learning business fundamentals
Other
How would you rate your previous experience with startups?
No experience
1
2
3
4
Extensive experience
5
1 is No experience, 5 is Extensive experience
Please indicate your level of agreement with the following statements:
Rows
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
I am committed to building a startup.
1
2
3
4
5
I am open to feedback and learning.
6
7
8
9
10
I am looking for a collaborative environment.
11
12
13
14
15
Preferred method for follow-up communication
*
Email
Phone
Video Call
Is there anything else you'd like us to know about your interest in the Startup Program?
Submit Survey
Should be Empty: