"Beyond the Middle" Capital Intensive - Initial Application

Basic Information

Company name*

Street address*

Street address 2

City*

State/Region*

Postal code*

Website URL

Social Media Links

if applicable

Contact Information

First name*

Last name*

Phone number

Phone Type

Email*

Company Overview

Industry

Choose the best option

Company Description

Briefly describe the products and/or services offered by your business

Year founded

Is your business currently operational?

Revenue Category

Funding & Capital Readiness

Have you raised capital before?

Yes

When do you plan to raise capital for your business?

As soon as possible

In the next 6-12 months

In the next 1-2 years

I do not have plans to raise capital for my business

I am not sure, I need more guidance

Number of employees

Do you currently have plans to hire more employees or contractors?

Yes

Why are you interested in joining the Beyond the Middle Capital Intensive?

(500 words or less)

How did you hear about this program?

If "Other" please specify

Once you submit this form, your application will be reviewed, and you will be notified if you have advanced to the next stage of the application process.