Pitch Summit Application

The Pipeline Fellowship is an angel investing bootcamp for women philanthropists. Fellows commit to invest in a woman-led for-profit social venture in exchange for equity and a board seat at the end of the training. The Pipeline Fellowship works to increase diversity in the U.S angel investing community and creates capital for women social entrepreneurs.

CRITERIA

Must be at least co-owned and co-founded by a woman
Must have a for-profit legal structure
Must demonstrate a social and/or environmental mission

DUE DATES

East Coast applications will close January 31, 2013.

To learn more, go to: http://pipelinefellowship.com
Questions? Email us: info@pipelinefellowship.com

Before submitting your application, please remember to pay the non-refundable US$40 processing fee. You will be prompted to do so at the end of the application.

General Information

Company Name *

Company URL (if any)

Company Legal Structure *

Where did you hear about the Pipeline Fellowship Pitch Summit? *

Founders

Founder Name (1) *

Gender *

Female

Male

Other

Ethnicity/Race

LinkedIn Profile

Twitter

City, State *

Country *

Founder Name (2)

Gender *

Female

Male

Other

Ethnicity/Race

LinkedIn Profile

Twitter

City, State

Country

Founder Name (3)

Gender *

Female

Male

Other

Ethnicity/Race

LinkedIn Profile

Twitter

City, State

Country

Contact Person *

Phone Number *

Email *

Questions

140 Character Business Pitch *

Business Summary *

How much financing has your company raised to date & from whom? *

How much capital is your company looking to raise in this round & where else are you looking for funding? *

Why equity? *

In what stage of growth is your company (i.e., prototype, pre-revenue, post-revenue, etc.)? *

Experience (Briefly describe relevant experience of founders. Why is this the right team to launch this startup?) *

Problem (What social and/or environmental problem does your company address?) *

Solution (How does your company propose to address this?) *

Inspiration (Describe the inspiration behind starting this company. What positive social/environmental outcomes were you hoping to achieve? What bout your idea keeps you up at night?) *

Customers/Market (Please describe your target demographic.) *

Business Model (How and from whom do you generate revenue?) *

Beyond the Bottom Line (How does your company incorporate social and environmental justice, environmental sustainability, and/or employee impact in its business model? Please address at least one of the issues below.) *

Measuring Impact (How do you measure non-financial success?) *

Competition (Who are your main competitors?) *

Scaling (Describe how your company will scale and what that will look like. What systems do you have in place?) *

Exit strategy (Explain if and how your company plans to exit.) *

Are any founders covered by non-competes or intellectual property agreements that overlap with your project? *

Yes

If you were selected for the Pipeline Fellowship investment, what would you use it for? *

The Pipeline Fellowship investment is in exchange for equity and a board seat. What skills are you currently looking for in a board member? How do you expect this board seat will benefit your company? *

The Last Word: Why should the Pipeline Fellows invest in you? *

ATTENDANCE By checking this box/these boxes I indicate that, if my company is selected, a woman founding team member will be available to participate in-person at the Pipeline Fellowship Pitch Summit at the date and city indicated below. I understand that companies requiring to pitch via phone or video may be disqualified from the investment process. Dates subject to change at Pipeline Fellowship's discretion. *

New York, NY (Monday, April 8, 2013)

EQUITY & BOARD SEAT REQUIREMENT By checking this box I acknowledge and agree on behalf of myself and on behalf of the entity submitting this application (the “Company”) that the Pipeline Fellowship expects to invest in equity securities of the Company and to receive one (1) corporate board seat. Companies that do not comply with these requirements may be disqualified from consideration for an investment and the Company’s application to the Pipeline Fellowship may be terminated. *

I understand the equity and board seat requirement.

INVITATION PROCESS By checking this box I acknowledge that the Pipeline Fellowship Pitch Summit invitation process will require a two-step application and that the second step is to follow. *

I understand that I will be required to sign an agreement before participating in the Pipeline Fellowship Pitch Summit.

Signature

Name of Company *

Name of Signatory *

Title with the Company *

In order to complete your application, please pay the US$40 registration fee via PayPal: https://www.paypal.com/cgi-bin/webscr?cmd=_s-xclick&hosted_button_id=TCSR28VD97FYQ

Only applications that include a valid PayPal transaction ID will be reviewed.

Pitch Summit Application

Before submitting your application, please remember to pay the non-refundable US$40 processing fee. You will be prompted to do so at the end of the application.

General Information

Founders

Questions

Signature

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