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100 Startup Project: Membership Application

Thank you for your interest in the Levan Center of Innovation's 100 Startup Project. We understand the challenges that come with being an underserved entrepreneur, and we're here to support you on your path to success. Please complete the application form below to help us understand your startup's needs and potential. If selected, you'll receive a one-year membership to the Levan Center of Innovation, granting you access to invaluable resources, mentorship, and a supportive community—all designed to fuel your startup's growth and success. Don't miss this chance to elevate your entrepreneurial journey. Apply now and take the first step toward unlocking a world of opportunities

COMPANY & FOUNDER INFORMATION
    Founder's Gender
    Founder's Race & Ethnicity
    • Asian
    • Black, Hispanic
    • Black, Non-Hispanic
    • Native American
    • Pacific Islander
    • White, Hispanic
    • White, Non-Hispanic
    • Middle Eastern North African (MENA)
    • Other
    If Applicable
    DESCRIBE YOUR STARTUP
      What problem does your startup aim to solve?
      • {name}
      What stage is your startup currently at?
      How does your startup utilize technology to drive innovation?
      • {name}
      IMPACT & VISION
        How do you envision your startup making a positive impact in your industry or community?
        • {name}
        What are your long-term goals and aspirations for your startup?
        • {name}
        FINANCIAL NEED
          Please provide a brief explanation of your financial situation and how the scholarship would benefit your startup.
          • {name}
          COMMITMENT
            By checking this box, I commit to being an engaged member of the Levan Center of Innovation community, by spending time in the Levan Center, participating in programs, events, and utilizing the resources offered.
            How do you plan to leverage the resources provided through the scholarship to accelerate the growth of your startup?
            • {name}
            REFERENCES
              Please provide the contact information for two references who can speak to the potential of your startup (e.g., mentors, industry professionals, etc.).
              • {name}

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