Innovation Works: Introductory Questionaire
start
 
Here are some things that make you a great fit for Innovation Works business resources (including funding):

- U.S. owned
- Located in Southwestern Pennsylvania
- Currently employ fewer than 50 people
- Developing an innovative technology in an area such as: life sciences (medical devices and biotechnology), information technology (hardware, software, internet infrastructure)
- Innovative products or tech enabled services addressing large market opportunities
- A clear and compelling value proposition
- A strategy to achieve full-scale commercialization
- Entrepreneurs and other leaders possess passion and dedication to the commercial success of the company
- Potential to attract additional funding if needed

 
Getting Started

We encourage applications from entrepreneurs of all backgrounds. For us to get to know some more information about your company please answer the questions below. Fields with an “*” are required by the state of Pennsylvania.
 
Contact Information

 
First Name *

 
Middle Name

 
Last Name *

 
Company Name *

 
Job Title *

Founder, CEO, CTO, COO, etc.
 
Address *

 
City *

 
Zip code *

 
Municipality *

 
Phone Number *

 
Website

 
Additional Company Information

 
A brief company description. *

 
What makes your company unique [100 words or less].

 
Is your company currently located in Pennsylvania? *

     
 
Company Legal Type *


 
If a Corporation, what is the date of incorporation?

 
Concept stage: *


 
Number of full-time employees *

 
Please list the names and roles of current team members *

Name...
Role...
 
Has your company raised investment from any of the following sources?:


 
Has your company raised investment from any of the following sources?:


 
Amount of investment raised from the sources above. *

(in dollars)
 
Is your company currently raising funds, what is the amount that you’re seeking?

 
Beyond funding, what other ways can we help your company?


 
Terms and Agreements *

Innovation Works is a non-profit economic development agency serving the citizens of southwestern Pennsylvania. If we agree to provide you with business assistance, we will do so at no charge to you. We disclaim (and you waive) all warranties related to the assistance we may provide to you, and you also agree that neither Innovation Works, its directors, officers, employees nor agents shall be liable to you for any damages, including, without limitation, loss of profit or business opportunity.I agree(Have Deborah review Terms/Agreements)
     
 
Please attach your business plan or executive summary. If you do not yet have a business plan or any additional documents to upload, no worries you can leave this blank.

Thank you for your interest in Innovation Works. We look forward to connecting with you and learning more about your business.
We will be contacting you shortly.
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