UVM INNOVATIONS FUND
APPLICATION FORM
Name:
UVM address:
Phone:
Email:
Brief description of the technology and the work that led to it:
Amount requested (line item budget of direct costs):
Proposed use of funds:
(continued)
UVM INNOVATIONS FUND
APPLICATION FORM
Page 2
Timeframe for completion of grant-related work, including anticipated milestones:
Please submit your business plan as an attachment, including the following information:
Executive Summary
Business Definition
Market Analysis
Management Plan
Financial Projections
Outcomes and Future Direction
Note: If possible, please include descriptions of your competitive strengths, weaknesses,
opportunities, and threats in the plan.
Submitted by:
(signature)
Note: It is acknowledged by signing this form that the funds granted will be invested with a Convertible
Note. That means that when sufficient capital is raised, the note may be converted to either additional
equity or repaid as a loan. The amount of capital to be raised shall be agreed upon prior to signing the
note, as will the discount on equity conversion or interest on the loan. A copy of the Note boilerplate is
available.
Submit