Accelerator Centre Intake Form

Think you have what it takes to be an Accelerator Centre Client?
Whether you are one step away from taking your product to market, or an experienced startup looking for executive guidance, our program will match your needs. We strive to create the best technology companies coming out of our Centre- globally relevant, revenue generating, and built to scale.
Candidates applying to the Accelerator Centre should be open and receptive to mentoring, and ready to work through milestones with accountability. 
Here’s how it works:
 
  1. Complete and submit the application form.
  2. We will contact your company if we are interested in an initial meeting.
  3. During our meeting, you’ll learn about our program and you can tell us about yourself and your business.
  4. We figure out if the Accelerator Centre is the best fit for you.

First Name*

Last Name*

Company Name*

Company Website*

Your role in the company*

Your E-mail*

Your Phone*

Address line 1*

Address line 2*

Address line 3*

Your City*

Province/State/County*

Postal Code/Zip Code*

Your 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.