VentureCatalyst Intake Form

VentureCatalyst Application

Welcome, we're glad you're working on a startup and look forward to working with you! Please complete this form to the best of your ability to apply to VentureCatalyst. If you have any questions, please see an CEO team member.


Welcome	Founder	Signature

Startup Information
Name of your company, product, or team? *
N/A

(Don't worry, you can change this later. We just need to know what to call you.)
Describe your startup in three sentences (this will be PUBLIC): *
N/A

This description will be publicly shared in correspondence with alumni and mentors. Please do NOT put sensitive or intellectual property details in this form.
Describe your startup in greater detail (this is PRIVATE; max 250 words): *
N/A

This information is confidential. You MAY include details on intellectual property here.
Which of these best describes your startup? *
N/A

Involves a new invention or innovation. We are building a new device, software, or type of service that could be sold globally.
Local store, services I will perform, or an e-commerce website.
Came out of technology or research developed at MSU.
I'm unsure and need help.
What is the state of development of your idea? *
N/A

Just an idea
We have a rough business model sketched out
We have a proof of concept and solid market research completed
We have a working prototype being tested by potential customers
We are generating revenue

Help us gauge where you are in the startup process
Which E-Center location would you prefer to work with? *
N/A
What Can We Help You With?

Please share with us the top two things you'd like help with today.
I need help with
N/A
I also need help with
N/A
Disclosure Statement
Intellectual Property
This form and its contents are treated by the Center for Entrepreneurship & Outreach (CEO) as confidential. Submissions are property of the person(s) remitting, subject to IP restrictions defined in MSU OP 76.01. The CEO is a non-profit organization focused on helping you turn ideas into reality, not derive benefit from it.

Ineligible Businesses
The following organizations are ineligible for VentureCatalyst and other E-Center venture development or support programs:
- Charitable, religious, government-owned corporations consumer and/or marketing cooperatives, churches or organizations promoting religious objectives, or other non-profit or eleemosynary institutions.
- Pyramid sales plans, where a participant's primary incentive is based on the sales made by an ever-increasing number of participants. Such products as cosmetics, household goods, and other soft goods lend themselves to this type of business.
- Firms involved in illegal activities that are against the law in the jurisdiction where the business is located. Included in these activities are the production, servicing, or distribution of otherwise legal products that are to be used in connection with an illegal activity, such as selling drug paraphernalia or operating a motel that permits illegal prostitution.
- Gambling activities, including any business whose principal activity is gambling. While this precludes loans to racetracks, casinos, and similar enterprises, the rule does not restrict loans to otherwise eligible businesses, which obtain less than one-third of their annual gross income from either the sale of official state lottery tickets under a state license, or legal gambling activities licensed and supervised by a state authority.
Under no circumstances will MSU provide financial support to any business that is (or otherwise perceived to be): (a) based in a foreign country; (b) engaging in any activity that is illegal under federal and/or state law; (c) lewd or sexual in nature; (d) promoting violence or drug use; (e) gambling.
I acknowledge the terms and conditions above. *
N/A

Yes
No

Primary Founder Contact Information

This person will be the primary contact for the startup.
Name
N/A

Required First Required Last
Email *
N/A
Cell Phone Number *
N/A

### ### ####
Startup Role
N/A

BUSINESS (Product, Financial, Marketing, or Sales)
TECH (Engineer, Programmer)
CREATIVE (Design, Marketing)

Please select the description you most readily identify with
Demographic Information
Gender
N/A

Male
Female
Ethnicity
N/A

American Indian
Asian
Black or African American
Hispanic or Latino
Indian
Multiracial
Hawaiian or Pacific Islander
White or Caucasian
Other
Home City
N/A
Home State
N/A
Birth Date
N/A

MM/dd/yyyy

Only so we can wish you happy birthday :)
University Information
University Affiliation *
N/A

Student (Undergraduate)
Student (Graduate)
Faculty
Staff
Non-MSU (Community)
MSU NetID
N/A
Major
N/A
Expected Graduation
N/A

MM/dd/yyyy

Team Commitment Acknowledgement
I, on behalf of our team, fully commit to make a strong, good faith effort to complete the entire VentureCatalyst Program and its five stages, unless the market gives clear, negative indications of success and I have exhausted all reasonable alternative business model strategies.

Additionally, during the VentureCatalyst Program, I understand I may be awarded grant funds by the MSU Center for Entrepreneurship and Outreach (CEO). Please initial the following:
Please check the boxes to acknowledge the committment *
N/A
Further, I understand that if I or my team members fail to adhere to the above requirements or, if in the opinion of program personnel, fail to maintain the spirit of this commitment, we may be required to return unused grant funds and declared ineligible for future funding opportunities.
Signature *
N/A

E-Signature Field
Clear
Today's Date *
N/A

MM/dd/yyyy
Program *
N/A
Stage *
N/A
Closing Date *
N/A

MM/dd/yyyy

1/3

2/3

3/3

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