Founders Program – Pathfinder & Base Camp Application Form

Founders Program Pathfinder Base Camp Application Form

Information that is provided remains confidential and will only be used for internal purposes.

Tell us about yourself
Applicant Name*
First Last
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Email*
Phone*
How did you hear about the Founders Program?*
Do you identify as any of the following?*
There are a variety of funding options available that North Forge may be able to identify for your startup. May select more than 1 option.
What skills & experience do you bring to the business?*
Experience, education etc.
Tell us about your co-founders
If you do not have co-founders, please disregard this section.
Co-founder name(s)
Co-founder address(es)
Please put in order of previously listed co-founders.
Co-founder email (s)
Please put in order of previously listed co-founders.
Co-founder phone number(s)
Please put in order of previously listed co-founders.
What skills & experience do your co-founder(s) bring to the business?
Experience, education etc.
Tell us about your business
Company name*
Company address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Is your business registered or incorporated in Canada?
- Registered
- Incorporated
Who will be the primary contact for the business?*
Must be a founder or co-founder
What stage of the North Forge Founders Program would you like to be considered for?*
Pathfinder: identification of early adopter/key customer, customer interviews, market and assumption validation. Base Camp: developing a sustainable business model with a framework that validates your business model assumptions.
Tell us about your startup
What problem do you solve for an individual, business or industry?*
How do you propose to solve that problem?*
What is your solution/product (explain in detail)
How would you best classify your business?*
May select more than 1 option
Does your solution, or part of your solution, require industrial design, prototyping, and/or manufacturing?*
How much time can you (and co-founders if applicable) commit to working on your startup each week?*
Share with us what you have done (to date) to launch your startup.*
What is your business model?*
Have you or are you currently working on any of the following:
May select more than 1 option
Tell us about your customer
Have you identified who your early adopter or key customer is? If yes, please describe them.*
Have you conducted primary research and validated your assumptions of early adopters through customer interviews? If yes, how many have been completed?*
Friends/family interviews do not apply
How did you hear about us?*

DARE TO DO

FIND A LOCATION

WINNIPEG

CEO: Joelle Foster

441 – 100 Innovation Drive
Winnipeg, Manitoba R3T 6G2• P: 204-262-6400

PINAWA

President: Shane Li

24 Aberdeen Avenue
Pinawa, Manitoba R0E 1L0 • P: 204-753-5170

WINNIPEG

Vice-President: Marney Stapley

125 Adelaide Street
Winnipeg, Manitoba R3A 0W4 • P: 204-799-2033

THE PAS

University College of the North
436-7th Street East, The Pas, Manitoba R9A 1M7
(204) 623-0311

Founders Program – Pathfinder & Base Camp Application Form

Founders Program Pathfinder Base Camp Application Form

Tell us about yourself

Tell us about your co-founders

Tell us about your business

Tell us about your startup

Tell us about your customer

FIND A LOCATION

WINNIPEG

CEO: Joelle Foster

441 – 100 Innovation Drive Winnipeg, Manitoba R3T 6G2• P: 204-262-6400

PINAWA

President: Shane Li

24 Aberdeen Avenue Pinawa, Manitoba R0E 1L0 • P: 204-753-5170

WINNIPEG

Vice-President: Marney Stapley

125 Adelaide Street Winnipeg, Manitoba R3A 0W4 • P: 204-799-2033

THE PAS

University College of the North 436-7th Street East, The Pas, Manitoba R9A 1M7 (204) 623-0311

Founders Program Pathfinder Base Camp Application Form

Tell us about yourself

Tell us about your co-founders

Tell us about your business

Tell us about your startup

Tell us about your customer

441 – 100 Innovation Drive
Winnipeg, Manitoba R3T 6G2• P: 204-262-6400

24 Aberdeen Avenue
Pinawa, Manitoba R0E 1L0 • P: 204-753-5170

125 Adelaide Street
Winnipeg, Manitoba R3A 0W4 • P: 204-799-2033

University College of the North
436-7th Street East, The Pas, Manitoba R9A 1M7
(204) 623-0311