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Bluerock Accelerator Program Registration Form
Founder Information
First name
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Last name
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Date of birth
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Email
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Phone number
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Country/Region
Gender (Male/Female)
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Business Information
Name of business
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Website URL
What Industry is your business?
Please Select
Agritech
Fintech
Edutech
Mobility Tech
Healthtech
Artificial Intelligence
Others
Brief Description of Business
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Year founded
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Location
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Number of employees
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Please Select
1
2-5
5-25
25-50
50-100
100-500
500-1000
1000+
Business Metrics
Annual revenue
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User Traction
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Funding Raised (If Any)
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Use "Nil" if none
Key Milestones Achieved
UN Sustainable Development Goals (SDGs) Alignment
Which SDGs does your startup align with? (Select all that apply)
SDG 1: No Poverty
SDG 2: Zero Hunger
SDG 3: Good Health and Well-being
SDG 4: Quality Education
SDG 5: Gender Equality
SDG 6: Clean Water and Sanitation
SDG 7: Affordable and Clean Energy
SDG 8: Decent Work and Economic Growth
SDG 9: Industry, Innovation, and Infrastructure
SDG 10: Reduced Inequality
SDG 11: Sustainable Cities and Communities
SDG 12: Responsible Consumption and Production
SDG 13: Climate Action
SDG 14: Life Below Water
SDG 15: Life on Land
SDG 16: Peace and Justice Strong Institutions
SDG 17: Partnerships to achieve the Goal
Additional Information
Why do you want to join the BlueRock Accelerator Programme?
What are your expectations from the programme?
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What is your business funding requirement?
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How did you hear about the BlueRock Accelerator Programme?
Required documents for upload
Provide your Business Pitch Deck
Submit a short video of your business (Less than 3mins)
I hereby declare that the information provided in this application is true and correct to the best of my knowledge and belief. I understand that any false information may result in the disqualification of my application.
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