KTEC PIPELINE Entrepreneur Fellowship Application

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KTEC PIPELINE Application

Early Application deadline is August 3, . Regular application deadline is September 21, .


*First Name
*Last Name

*Birth Date  (mm/dd/yyyy)
*Birth City
*Birth State / Country

*Mailing Address
*City
*State
*Zip Code
*Primary Phone  (555-555-5555)
*Email

*How did you hear about the PIPELINE?
*What is your product/service?
Number of Employees (if any):
*Tell us about your venture



*Please describe the specific business you will be working on during your year in the KTEC PIPELINE?


*What stage are you in development of your venture (how many years in existence, size of company, revenue, etc.)?


*Next to your role as CEO/Founder, what is the next important executive role in your company?


*Please list and explain at least three strengths and three weaknesses as an entrepreneur.


*Do you have any previous experience as an entrepreneur or with an entrepreneurial venture?
If yes, please explain this experience.


*Have you raised capital? If so, how much? How much capital will you need to raise in the next five years?


*What do you hope to accomplish this year in the KTEC PIPELINE Entrepreneur Fellowship program?


*Why do you feel you are entrepreneurially oriented?


*Where do you see your business in five years?


*What challenges are you facing or about to face with your venture?


Please attach your resume/CV.

Please provide a three page (no more than three pages) executive summary of your business plan.

*KTEC PIPELINE reserves the right to complete reference and background checks prior to your acceptance as an Innovator. By checking this box, you are willing to participate in all necessary procedures to complete this process.


*Denotes a required field.


KTEC: Kansas Technology Enterprise Corporation

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