Women in Tech Incubator (JumpSTART)

The information submitted as part of your application will be used to evaluate your venture’s candidacy to the Women in Tech JumpSTART program.

Please note that we may share information about your company with our funders in an effort to provide more tailored programming. If you have any concerns about this application or the use of your information, please email yspace@yorku.ca.

Page 1 of 2 - Startup Information

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Organization Legal Name *
Company Name *
JumpSTART programming is offered to companies where women own 50% or more of the company. Do you confirm that at least 50% of your business is owned by a women-identified founder? *

JumpSTART programming is offered to companies where women own 50% or more of the company. Do you confirm that at least 50% of your business is owned by a women-identified founder? Yes No
Have you previously been part of an incubator or accelerator program? *

Have you previously been part of an incubator or accelerator program? Yes No
Do you confirm that your company is an Ontario-based tech venture or a tech venture looking to expanding into York Region, Ontario? *

Do you confirm that your company is an Ontario-based tech venture or a tech venture looking to expanding into York Region, Ontario? Yes No
Web Site *
Are you incorporated? *
Business Number *
Year of Incorporation (If you answered "Yes" above) Year of Incorporation (If you answered "Yes" above) / MM / DD YYYY
Type of Organization *

Type of Organization Incorporated Company (Name includes Ltd., Inc., or Corp.) Partnership, Limited Partnership, or Joint Venture Sole Proprietorship Individual (not a registered business) Band or Indigenous Community-owned Incorporated Company Non-profit organization Please Specify Please Specify
Primary Contact Primary Contact * First Last
Are you currently working on your company full-time (35+ hours / week)? *

Are you currently working on your company full-time (35+ hours / week)? Yes No
Email *
Phone Phone * - ### - ### ####
Personal Address Personal Address
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Links to online profiles *

Links to online profiles like Twitter, LinkedIn, Facebook, Crunchbase, AngelList, Github, or any other online sources for reference.
Upload a pitch deck or any supporting documentations

Attach Files
How did you hear about the program? *

How did you hear about the program? Facebook Twitter Linkedin Instagram YSpace Newsletter Community Partners JumpStart (Treefrog & Schulich) Referral (Please state the name of the referral partner)
BUSINESS INFORMATION

Please answer the questions accurately as due diligence will be performed upon acceptance.
Elevator Pitch (Briefly describe your venture and communicate it's core value.) *
Maximum of 100 words allowed. Currently Entered: 0 words.
Business Address Business Address *
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
At what stage is your company currently at? *

At what stage is your company currently at? Ideation (Entrepreneur with idea; initial market and technology exploration) Discovery (Value proposition established; testing ideas; proof of concept achieved; identifying customers; earlier financials) Efficiency (Initial market traction; scaling sales and marketing; demand creation; forecasting based on actuals) Scale (Validated product and market; customer growth; established management team)
What industry does your venture fall under? *

What industry does your venture fall under? Agriculture, forestry, fishing and hunting Mining, quarrying, and oil and gas extraction Utilities Construction Manufacturing Wholesale trade Retail trade Transportation and warehousing Information and cultural industries Finance and insurance Real estate and rental and leasing Professional, scientific and technical services Management of companies and enterprises Administrative and support, waste management and remediation services Educational services Health care and social assistance Arts, entertainment and recreation Accommodation and food services Other services (except public administration)

Please answer the following questions in regards to the stage of your venture: *
	Yes	No
Do you have any paying customers?	Do you have any paying customers?Yes	Do you have any paying customers?No
Do you have any non-paying users/customers or any pilot projects underway?	Do you have any non-paying users/customers or any pilot projects underway?Yes	Do you have any non-paying users/customers or any pilot projects underway?No

What was your revenue in the past 12 months? *

What was your revenue in the past 12 months? $1 - $10,000 $10,001 - $50,000 $50,001 - $100,000 $100,001 - $500,000 $500,001 - $1,000,000 $1,000,000 and above
What is your monthly recurring revenue? *

What is your monthly recurring revenue? $1 - $1,000 $1,001 - $3,000 $3,001 - $5,000 $5,001 - $7,000 $7,001 - $10,000 $10,001 - $15,000 $15,001 - $20,000 $20,001 - $30,000 $30,001 - $50,000 $50,001 - $100,000 $100,000+
If you have raised funding, how much money have you previously raised from public sources (i.e. grants, loans, competitions, etc.) *
If you have raised funding, how much money have you previously raised from private investors (i.e. Angels, Venture Capitalists, Private Equity Funds, etc.) *
Please identify the areas where you need immediate support: * *

Please identify the areas where you need immediate support: * Defining Overall Business Strategy Optomizing Sales and Business Development Determining how to grow the team Connecting with industry/academic/government partners Personal Growth & Development Understanding my business financials Fund Raising Other Other
Please identify 2-3 key milestones that you find critical for your venture over the next 3 months *
Maximum of 250 words allowed. Currently Entered: 0 words.
BUSINESS MODEL

Please talk to the various components of your business model and it's scaling opportunities.
What is the problem that your business is trying to solve? *
Maximum of 100 words allowed. Currently Entered: 0 words.
What is your solution to the problem? *
Maximum of 100 words allowed. Currently Entered: 0 words.
What is your main target market? *
Maximum of 100 words allowed. Currently Entered: 0 words.
Explain the demographics and tell us why.
What is your competitive advantage? *
Maximum of 100 words allowed. Currently Entered: 0 words.
PERSONNEL/TEAM INFORMATION

Please provide details of all your team members, including the "Primary Contact" mentioned above.
Number of Founders *

Total number of all equity sharing co-founders, not including employees, contractors, advisors or volunteers
How many non co-founder team members do you have? *

Include any employees, and contractors. Do NOT include co-founders, mentors, volunteers or advisors.
Number of women identifying founders *

Include any employees, and contractors. Do NOT include co-founders, mentors, volunteers or advisors.
Number of full-time employees that work for your company (not including founders): *

Include any employees, and contractors. Do NOT include co-founders, mentors, volunteers or advisors.
Number of part-time employees that work for your company (not including founders): *

Include any employees, and contractors. Do NOT include co-founders, mentors, volunteers or advisors.
Number of York University students that are involved in your company: *

Include any employees, and contractors. Do NOT include co-founders, mentors, volunteers or advisors.
Information of Founder #1
Founder 1 Full Name Founder 1 Full Name * First Last
Email *
Role of Founder *
Maximum of 100 characters allowed. Currently Entered: 0 characters.
Highest Level of Education Completed *

Highest Level of Education Completed High School College University Other Other
Which University or College did you graduate from? *

If this does not apply, please put N/A
Information of Co-Founder #2
Co-founder 2 Full Name Co-founder 2 Full Name * First Last
Email *
Role of Founder *
Maximum of 100 characters allowed. Currently Entered: 0 characters.
Highest Level of Education Completed *

Highest Level of Education Completed High School College University Other Other
Which University or College did you graduate from? *

If this does not apply, please put N/A
Information of Co-Founder #3
Co-founder 3 Full Name Co-founder 3 Full Name * First Last
Email *
Role of Founder *
Maximum of 100 characters allowed. Currently Entered: 0 characters.
Highest Level of Education Completed *

Highest Level of Education Completed High School College University Other Other
Which University or College did you graduate from? *

If this does not apply, please put N/A

Women in Tech Incubator (JumpSTART)

Women in Tech Incubator (JumpSTART)

Page 1 of 2 - Startup Information

BUSINESS INFORMATION

BUSINESS MODEL

PERSONNEL/TEAM INFORMATION

Information of Founder #1

Information of Co-Founder #2

Information of Co-Founder #3