Name
*
First Name
Last Name
Email
*
Phone
*
(###)
###
####
Postal code
*
Please select your age:
*
Please select your gender:
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Female
Male
Transgender
Gender Non-conforming/Non-binary
None of the above
Please select your race/ethnicity:
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White
Black or African American
Hispanic or Latino
Asian or Asian American
American Indian or Alaska Native
Native Hawaiian or other Pacific Islander
Another race/ethnicity
Are you a current or former member of the U.S. Military or National Guard?
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Do you have a physical or mental impairment which substantially limits you in one or more major life activity; or have a record of having such an impairment; or are regarded as having such an impairment?
*
What is the highest level of education you have completed?
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What is your current annual income?
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Venture Name:
*
In 40 words or less, please describe your venture:
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Which of the following best categorizes your venture?
*
Please classify your venture:
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Which stage is your venture currently in?
*
Which of the following best describe how you plan on working within your venture?
*
Attendance during this program is vital to receiving consistent guidance and direction for your business. The cohort portion of the program meets every Tuesday for 10 sessions beginning on February 4, 2025. Each session will run from 9:00 AM - 12:00 PM. Are you ready to commit to attending consistently?
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By checking "No", you are effectively removing yourself from the application process at this time.
The cost of this program is $500. This amount must be paid in full prior to the start of the first cohort meeting. Without a completed payment, participants will be unable to begin the program. Are you ready to commit to the cost of the program?
*
By checking "No", you are effectively removing yourself from the application process at this time.
Thank you for your application to The Cultivate Program at StartUP Columbus.
For any additional questions, please contact info@startupcolga.com.
