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In partnership with Strategic Investment Management Inc., and the Venture Capital fund, the Internet Incubator Fund Limited Partnership, we now provide Internet Incubation services. We can provide seed level capital, and offer our web and e-commerce design, programming, hosting, maintenance and marketing skills and services. We can help with management, hiring, the board of directors, business development and strategic planning. We can then help provide further venture financing, and help build the business and eventually take the company public.

If you would like to be considered for our Incubator program, please complete the following form, and we will contact you after we have had a chance to review your project.

Describe your company in one sentence.

500 word short description of your business plan.

Your Name

Your Email

Company Title

Company Name

Company Street Address

Company City

Company State

Company Zip/Postal Code

Company Country

Company Web Site

Company E-Mail

Company Phone Number

Company Fax Number

Company Structure

C Corporation
S Corporation
Limited Liability Company (LLC)
Partnership
Sole Proprietorship

If incorporated, date of incorporation (mm/dd/yyyy)

If incorporated, state of incorporation (2 letter state code)

At what stage of development is your company today?

Startup
Product Development
Beta Test / Clinical Trials
Shipping Product
Profitable

Please give all monetary amounts in $ U.S.

How much capital has been invested in your company to date?

How much capital is your company seeking now?

If we fund you with this amount, how many days will that last you?

After this time period, how much additional financing, if any, will you be seeking in the next round of financing?

How much capital (including what you are now seeking) will it take for your company to reach a positive cash flow state of operations?

Please keep your answers to each of the following questions to about 300 words. Thank you.

What is your company's mission statement?

What solution to what problem are you aiming to provide with your product or service?

What are your company's key goals?

Describe the hardware and software you will be using for your business. Please discuss any other underlying technologies you are employing. If you will be using any proprietary technologies, have you licensed them, or do you have an agreement to use them?

Outline your company's manufacturing and/or development process, if applicable.

When and how will investors get a return on their investments?

Why do you want to found a startup?

How many full-time employees does your company have?

How many part-time employees does your company have?

List the 6 most important people affiliated with your company (including yourself, company founders, key employees, Board members and advisors); and briefly describe their relevant education, experience and connections, if any.

You

Most Important #2

Most Important #3

Most Important #4

Most Important #5

Most Important #6

What is your company offering in exchange for financing? (check all that apply)

Equity
Convertible Debt
Debt
I'm not sure

Is there anything else we should know about you and your company?

How did you hear about us?

If you are completely finished with your application, click the Submit Incubation button.

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