www.starburstaccelerator.com
Application Form
STARBURST ACCELERATOR
Administration
After your project has been selected, we will ask you to
send us a certificate of incorporation of your company as
well as the documents that justify its status.
Engagement
The CEO certifies that the information given in the
inscription form is correct and can be trusted.
Confidentiality
The members of the jury and everyone else that has
access to the application forms is obliged to keep all
information concerning the projects strictly confidential.
Contact
François CHOPARD | IMPULSE PARTNERS
contact@starburstaccelerator.com
Phone: +33 (0)6 89 83 65 95
www.impulse-partners.com
0. Abstract
Name of the Company
Date of Creation
Elevator pitch (5 lignes)
Name and surname of the CEO (s)
% of capital
History and Prospects
2012
2013
2014
2015
2016
Realized
Realized
Realized
Estimated
Prospected
Earnings
Costs
Earnings before taxes
Amount of received or raised financing
2012
2013
2014
Contacts
Phone
Adress
E-mail
Needs in terms of incubation
Number of square meters or desks needed
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1. Your product
Description of your key technology (patents, level of maturity…)
Pending developments, To dos, plans and risks associated
What can your product offer? What kind of client needs does it fulfill?
In which aspect your product is better than others on the market?
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2. Your market
Who are the clients you target and what are their expectations?
What is the market value? In which geographical scope do you plan to operate?
What is your business model?
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3. Finance
The most important hypotheses of your business plan
Sales
Costs
Shareholder structure
Amount of capital
Distribution of capital
Financing Plan
2013
2014
2015
Selffinances
Loans
Subventions
Treasury Plan
2013
Trim. 4
2014
Trim. 1
Trim. 2
2015
Trim. 3
Trim. 4
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Trim. 1
Trim. 2
Trim. 3
Trim. 4
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4. Human Resources
Experience of every project leader
Today’s Team
Of which R&D
Number of
employees
Of which Marketing &
Sales
Roles
Prospected evolution of the number of employees
2013
2014
2015
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2016