Accelerator Application Form

Please submit your application to our Accelerator program.We are looking forward to reading about your ground breaking ideas, meeting entrepreneurial spirit and motivated founders. Make us believe in your vision and we will help you take off!

We are looking forward to receiving your application.

First Name*

Last Name*

Company Name*

Company Website*

Your role in the company*

Your E-mail*

Phone Number*

Address*

City*

Province/State/County*

Postal/Zip Code*

Country*



Kitchener-WaterlooStratford



Concept/DiscoveryDevelopment/ValidationLaunch/EfficiencyGrowth/Scale











YESNO







What was your revenue for the last fiscal year?



YESNO

YESNO



VelocityCommunitechWLU LaunchpadConestoga AMT Catalyst

Venture CapitalBootstrappingGovernment FundingAngel Funding



BootstrappedAngel FundingGovernment FundingVenture CapitalI don't have funding but can pay for the programI cannot afford to pay for the program




By clicking "Submit" below, you are giving permission to the Accelerator Centre to confidentially store and review this information for the purposes of intake into the program. You are also representing that all the information provided is true and accurate to the best of your knowledge.