Evolve Needs Assessment Form
This assessment is used in part to determine the eligibility for acceptance in Evolve. Additional information may be required as part of the application process. Please do not include any proprietary information. All information and data are confidential.
First and Last Name
What category does your company fall into? *
- Bio/Life Sciences
- Biotechnology
- Engineering
- Engineering - Medical
- IT - Software
- IT- Hardware
- X: Other
Is the company registered? *
- Yes
- No
Demographic Information:
Is the company women-owned? *
- Yes
- No
Is the company veteran-owned? *
- Yes
- No
Is the company minority-owned? *
- Yes
- No
Racial demographic *
Select all that applies:
- American Indian/Alaska Native
- Asian
- Black or African American
- Native Hawaiian or Other Pacific Islander
- White or Caucasian
- Other
Hispanic/Latino *
- Hispanic or Latino
- Not Hispanic or Latino
Company Information:
Provide company description with its product/service and business model. *
- {name}
Does your company have a formal business plan or business canvas? *
- Yes
- In Development
- No
Do you have intellectual property, patents, or copyrights? *
- Yes
- No
History of the Company: *
- {name}
Why was the company formed? *
- {name}
Describe your current business status and operations. *
- {name}
Which of the following structures are currently practiced by your company? (Select all that apply) *
- Management Teams
- Board of Directors
- Advisory Boards
- Other
Please list your management team and their experience. *
If applicable, include your advisory board.
- {name}
If applicable, list any business partners. *
- {name}
What are your company's competitive advantages? *
- {name}
Describe your current/potential customers and market segment. *
- {name}
What are the major risks to your company's success? *
- {name}
What is your exit strategy? *
- {name}
Has your company secured any investments? *
- Yes
- In-Development
- No
My company has received grant funding. *
- Yes
- Pending
- No
Describe in detail the financing needs of the company within the first 12 months and up to five years, if possible. *
(indicate amounts, sources, and resources)
- {name}
Program Questions:
Why do you want to be part of Evolve? *
- {name}
What are the immediate business needs of your company? *
Select five that you will need assistance with upon joining Evolve:
- Business Design and Ideation
- Business Model Canvas Composition
- Business Skill Development
- CEO/Executive Development
- Customer Discovery and Value Proposition
- Developing Business Pitch
- Fundamentals of Starting a Business
- Grant Writing and Training
- Investment Training
- Loans and Funding for Company
- Technical Assistance
- Other
Expand and describe in detail the types of services required based on the selected business needs above: *
- {name}
What is your connection to USF, if any? *
- {name}
I am willing to form an advisory board.
I am willing to participate in quarterly business reviews.
I am willing to meet regularly with a business coach/entrepreneur-in-residence.
I am willing to participate in all program activities recommended by Evolve?
When do you anticipate starting the program? *
Programming in Fall, Spring, and Summer
- Fall
- Spring
- Summer
How did you hear about Evolve? *
- Email
- USF Connect Newsletter
- Incubator Website
- Networking Event
- Newspaper
- Posted Flier
- Referred by Current Incubator Member
- Referred by Faculty Member
- Referred by Friend or Family
- Referred by Service Provider
- Referred by FSBDC
- Social media
- Student Organization or Club
- Web Search
- Other
Certification and Release:
All of the statements made in this assessment are true, accurate, and complete to the best of my knowledge. I understand that any false statement or material omission may lead to the disqualification of this assessment, or eviction from the Incubator if admitted to the residency.
Further, I understand this assessment will require additional supporting materials and may be reviewed by additional Incubator staff, and I release the information for examination by those individuals.
I agree to the above terms & conditions: *
Do not submit passwords through this form. Report malicious form