Project identification form

This preliminary information characterizes your project. It does not automatically determine your framework: in the next step, the four structures will be presented so you can choose the one that fits you. No scoring is applied here.

A · Identity of the applicant and the project

Applicant's name *

Position

Email address *

Gender

Nationality

Main country of operation *

Name of the enterprise / project *

Year of creation / registration

Short description of the project

B · Characterisation of the activity

Sector of activity *

Current legal status *

Team size

Stage of development *

Nature of the solution

Target geographical market

C · Turnover over the last 3 financial years (USD)

Turnover — Year 1 (the oldest)

Turnover — Year 2

Turnover — Year 3 (the most recent)

D · Intellectual property

Do you have one or more patents?

Other IP titles held

Trademark(s) Designs & models Plant variety certificate Software protection / copyright Trade secret None

E · Economic model and funding

Main revenue model

Funding already obtained

None Self-financing (founders) Debt (bank, microfinance, DFI) Grants / awards / donations Equity investors (business angels, VC) Mixed

F · Vision and needs

Target positioning in 3 years

Main support need