FARMERS2FOUNDERS Email Marketing -

Scale Accelerator Application Form

If you are having any trouble with this form, please reach out to admin@farmers2founders.com

First Name*

Last Name*

Phone*

Email*

State*

Postcode*

Gender*

Do you identify as an Aboriginal or Torres Strait Islander?*

LinkedIn Profile Link

Which option best describes you?*

About your startup

Startup Name

Describe your solution in 100 words or less*

Website (if you have one)*

Business Entity Type*

ABN (if applicable)

Date Founded (if applicable)*

Business Stage*

If you answered 'generating revenue' in previous question, please select one for your total annual revenue*

Number of employees (include Full Time, Part Time, and Casual)*

Please give some details around the specific challenges / problems that you believe your technology concept solves for your customers?*

Tell us about who your main customer segment is for your business?*

Who are your closest competitors?*

What evidence do you have that your product fits the market - progress to hitting your milestones? (e.g. customers and revenue)*

Have you raised investment previously?

Investment Amount

IP Ownership / Licensing*

Have our own registered IP

Have licensed IP (Exclusive)

Have licensed IP (Non-exclusive)

Do not have registered IP

Tell us about yourself (skills, experience, qualities)*

If you are a team, tell us about who is on it? Why are you the team to solve this problem? *

What do you hope to get out of the program?*

Anything else we should know?*

Referral Source*