Form

First name*

Last name*

Title*

What is your preferred name?

Company Name*

Email*

Phone number*

Street address*

City*

State *

Zip Code*

Twitter Handle

Website URL

Do you have an Employee Identification Number (EIN) or registered 501(c)3?

Company Description*

Two sentences or less please

What part of your company is tech focused?*

Stage of Company*

Type of Business*

B2B (Business to Business)

B2C (Business to Consumer)

Non-profit

What year was your startup founded?*

How are you currently funding your business?*

Total Revenue Generated Since Inception*

Total Capital Raised Since Inception*

Have you ever had a company be acquired?

Yes

Please share your military affiliation. Applying spouses who are not veterans or in the military are asked to please share their spouse's military affiliation as applicable.

Military Status*

Officer/Enlisted*

Are you or your spouse a wartime service connected disabled veteran (or eligible upon discharge)?*

DAV defines wartime service connected disabled veterans as any individual who served in a period of war or under conditions simulating war (1940-1976 and Nov. 4, 1979-present) who was wounded, disabled to any degree, or left with an illness as a result and who was discharged from military service with better than a dishonorable discharge. Veterans who identify as such do not need to have an approved or pending claim for VA disability benefits.

Pay Grade

Gender*

What pronouns do you use?

Ethnicity*

Personal Bio*

(400 characters or less) This is how you and your entrepreneurial effort will be presented if you are selected. Your submission will not be edited.

Is there anything else we should know about you or your company as part of our application review process?

How did you hear about DAV Patriot Boot Camp?*

Are you a DAV Member?*

DAV or DAV Auxiliary membership is not required for any services either organization provides.

Yes

Have you attended a Patriot Boot Camp event in the past?

Yes