Application

Before We Connect You...

This application helps us understand more about your company, what problem your solving and your key metrics. Please submit this in one sitting as the form won’t save your information. For questions, please reach out to the member of The Impact that invited you to join.

CEO email:

CEO first name:

CEO last name:

COMPANY INFO

Company name:

Company url (if applicable):

What problem are you solving?

Please share a product demo video. Share an unlisted YouTube/Vimeo video. Anything that shows the product works.

What stage are you? Your stage is the next round you're raising.

INDUSTRY VERTICAL

What sector of the cleantech world is your company part of?

Do you have a second industry classification?

PRODUCT

What is your product's TRL level?

Technology/Product description | What are you making?

Do you have any IP? If so, list the patent number and status below along with a short description of what's claimed.

Have you won any awards, grants or participated in incubators/accelerators? List them all below.

FOUNDERS

Founder 1 name

Founder 1 email

Founder 1 LinkedIn

Founder 2 name

Founder 2 email

Founder 2 LinkedIn

Founder 3 name

Founder 3 email

Founder 3 LinkedIn

COMPANY METRICS

Please share the primary KPI that defines the overall health of the company. This metric tends to demonstrate how much users love your product. We also ask for your secondary KPIs and some standard metrics.

Name of Primary KPI

Name of Secondary KPI

Name of Tertiary KPI

Total number of customers

Do you have any noteworthy customers or letters of intent?

Total revenue for 2021?

What is your current burn rate

How much does it cost to acquire a customer?

What is your current margin on each sale?