First Name
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Last Name
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Email
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Phone Number
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Company Name
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CRA Business Number (Optional)
Business and/or product/service description
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Are you located in Prince Edward Island?
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Yes
No
What sector best represents your business?
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Please enter data
Aerospace & Defense
Agriculture
BioTech/ BioScience
Clean Tech
Construction & Transportation
Cyber Security
Education
Engineering
Food & Beverage
Industrial Manufacturing
IT
MedTech & Pharmaceuticals
Natural Resources
Personal Services (Banking, Insurance, etc)
Professional Services
Real Estate
Tourism, Arts & Culture
Who are your competitors?
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What makes you unique from your competitors?
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Why is your product or service innovative?
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Number of founders/owners?
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Please enter data
1
2
3
4
5+
Is your company legally incorporated?
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Please enter data
Yes
No
Number of full-time employees:
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Please enter data
0
1
2
3
4
5+
Number of part-time employees:
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Please enter data
0
1
2
3
4
5+
List of employees and their roles (If applicable):
What stage is your venture at?
Please select an option
Ideation (Have a business idea/concept but have not yet started building the product or service)
Business Formation (Have a business concept and connecting with potential customers, but no technology built)
Proof of Concept (Have a basic protoype/MVP that works, but no customers yet)
Validation Stage (Have a selected group of customers testing/using the prototype/MVP)
Early-Revenue Stage/Investor ready (Have paying customers, but not yet a profitable venture)
Profitable/ Growth (The venture is cash-flow positive)
Have you received any funding? If so, how much? Do you have a plan on how you are going to finance your startup? If so, please elaborate.
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Your business' revenue stage is currently best described as:
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Please enter data
Pre-revenue (Not yet making money)
Monthly Recurring Revenue ( Steady stream of revenue every month)
In-between
If applicable, in the last calendar year, what was your business' total sales revenue?
If applicable, what are your revenue streams?
Are you profitable?
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Please enter data
Yes
No
Is there any Intellectual Property protection potential? If so, please explain.
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Have you/your business used accelerator, incubator, or other business/entrepreneur support programs in the past?
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Please enter data
Yes
No
On a scale of 1-5, one being low, 5 being high, please rate your knowledge on the following subjects:
Marketing
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Please enter data
1
2
3
4
5
Sales
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Please enter data
1
2
3
4
5
Business Finances/Taxation
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Please enter data
1
2
3
4
5
Human Resources
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Please enter data
1
2
3
4
5
Your product/service offering
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Please enter data
1
2
3
4
5
Please select all of the following business support organizations that you have already spoke with regarding your current venture.
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InnovationPEI
ACOA
NRC-IRAP
CBDC
Other
None of the above
What are your biggest challenges right now?
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What are your goals for the next three and six months?
What time of day do you see yourself using the space? (Select all that apply)
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Morning
Afternoon
Evening
Late Evening
How did you hear about us?
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Startup Zone Company
Social Media
Website
Tour / Event
Other
How did you hear about us? (Other)
Diversity and Inclusion: The section is voluntary and information collected is used solely for statistical purposes.
If applicable, please indicate if the applicant is led or majority led by one or more of the following under-represented groups:
Women
Indigenous peoples
Members of Official Languages Minority Communities
Youth
Persons with Disabilities
Newcomers to Canada and Immigrants
Black Communities
Racialized Communities
LGBTQ2
If applicable, please indicate if the project will benefit or encourage the inclusive growth of any of the following under- represented groups:
Women
Indigenous peoples
Members of Official Languages Minority Communities
Youth
Persons with Disabilities
Newcomers to Canada and Immigrants
Black Communities
Racialized Communities
LGBTQ2
Company Logo (if applicable)
Additional document 1 (optional)