Intake Form
About You
First Name
Last Name
Email
Phone Number
Company Name
Address
If your company has a website, please share
What fund are you interested in applying to?
Please select...
Health Fund
Social Impact Fund
Energy Fund
Are you a for profit or non-profit?
For-profit
Non-profit
Application Questions - Health
1. Please describe what your company does in one sentence (maximum 50 words)
2. Do you (Founders) or your company have a relationship with the University of Calgary? (a relationship can be but not limited to, graduate, IMPACT consulting, Research Initiative, Mentorship)
Yes
No - But we have a key faculty member identified
No -
We are interested in working with UCalgary faculty, CRO Services (
IMPACT
), and/or Clinicians
2.1. Please explain
2.11 Please provide the Name(s)
2.2. Was your technology derived from research conducted at the University of Calgary?
Yes
No
2.3. Please share the name of the Principal Investigator
Is your organization...
Pre-Revenue
Revenue Generating
3. How much capital are you looking to raise in total right now (dilutive funding)?
4. Do you have investment terms for the amount you are looking to raise?
Yes
No
4.1. Please explain
5. Did someone refer you to apply to UCeed?
Yes
No
5.1. Who?
6. Have you applied to UCeed before?
Yes
No
6.1 P
lease explain your progress since the last application (maximum 1,000 words)
Application Questions - Social For-profit
1. Please describe what your company does in one sentence (maximum 50 words)
2. Does your venture have economic or social impact in Alberta
Yes
No - But we plan to
No - We require assistance learning about the UCEED ecosystem
2.1. Please explain
2.2. Was your technology/service spun out of a non-profit entity?
Yes
No
Is your organization...?
Pre-Revenue
Revenue Generating
3. How much capital are you looking to raise in total right now (dilutive funding)?
4. Do you have investment terms for the amount you are looking to raise?
Yes
No
4.1. Please explain
6. Did someone refer you to apply to UCeed?
Yes
No
6.1. Who?
7. Have you applied to UCeed before?
Yes
No
7.1 P
lease explain your progress since the last application (maximum 1,000 words)
Application Questions - Social Non-profit
1. Please describe what your venture does in one sentence (maximum 50 word)
2. Does your venture have economic or social impact in Alberta
Yes
No - But we plan to
No - We require assistance learning about the UCEED ecosystem
2.1. Please explain
3. Did someone refer you to apply to UCeed?
Yes
No
3.1. Who?
4. Have you applied to UCeed before?
Yes
No
4.1 P
lease explain your progress since the last application (maximum 1,000 words)
Application Questions - Energy
1. Please describe what your company does in one sentence (maximum 50 words)
2. Do you (Founders) or your company have a relationship with any U15 university across Canada? (a relationship can be but not limited to, graduate, consulting, research initiative, mentorship)
Yes
No - We require assistance learning about the U15 ecosystem
2.1. Please explain the relationship.
2.2. Was your technology derived from research conducted at the University of Calgary?
Yes
No
2.3. Please share the name of the Principal Investigator
Is your organization...?
Pre-Revenue
Revenue Generating
3. How much capital are you looking to raise in total right now (dilutive funding)?
4. Do you have investment terms for the amount you are looking to raise?
Yes
No
4.1. Please detail - amount raising, company value, investment type (SAFE, Pref Shares...other), name of lead, and target close date.
6. Did someone refer you to apply to UCeed?
Yes
No
6.1. Who?
7. Have you applied to UCeed before?
Yes
No
7.1 P
lease explain your progress since the last application (maximum 1,000 words)
Please upload your pitch deck. If you don’t have a pitch deck, please click
here
to see a few example decks (maximum size 10 MB)
Contact Information
Intake Form
Intake Form