2012 GVSU Idea Pitch Competition Registration
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1
. Demographic Information
Demographic Information
Name:
Address:
Address 2:
City/Town:
State:
-- select state --
AL Alabama
AK Alaska
AS American Samoa
AZ Arizona
AR Arkansas
CA California
CO Colorado
CT Connecticut
DE Delaware
DC District of Columbia
FM Federated States of Micronesia
FL Florida
GA Georgia
GU Guam
HI Hawaii
ID Idaho
IL Illinois
IN Indiana
IA Iowa
KS Kansas
KY Kentucky
LA Louisiana
ME Maine
MH Marshall Islands
MD Maryland
MA Massachusetts
MI Michigan
MN Minnesota
MS Mississippi
MO Missouri
MT Montana
NE Nebraska
NV Nevada
NH New Hampshire
NJ New Jersey
NM New Mexico
NY New York
NC North Carolina
ND North Dakota
MP Northern Mariana Islands
OH Ohio
OK Oklahoma
OR Oregon
PW Palau
PA Pennsylvania
PR Puerto Rico
RI Rhode Island
SC South Carolina
SD South Dakota
TN Tennessee
TX Texas
UT Utah
VT Vermont
VI Virgin Islands
VA Virginia
WA Washington
WV West Virginia
WI Wisconsin
WY Wyoming
ZIP:
Email Address:
2
. Demographic Information (partner, if applicable)
Demographic Information (partner, if applicable)
Name:
Address:
Address 2:
City/Town:
Email Address:
Phone Number:
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3
. School Information
School Information
Year in School:
Major:
Major, 2nd:
Minor:
Minor, 2nd:
4
. School Information (partner, if applicable)
School Information (partner, if applicable)
Year in School:
Major:
Major, 2nd:
Minor:
Minor, 2nd:
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5
. How did you hear about the competition?
How did you hear about the competition?
Advertisement or Flyer
CEI Website
Email
Word of Mouth
Faculty
Other (please specify)
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6
. I am available the evening of October 18, 2012 for the Oral Pitch Presentations in Allendale (6pm).
I am available the evening of October 18, 2012 for the Oral Pitch Presentations in Allendale (6pm).
Yes
No
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7
. Select a Choice that Best Applies:
Select a Choice that Best Applies:
Existing Business
Start-up Stage
Idea Stage
Non-Profit/Social Impact
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8
. Please briefly describe your idea/company.
Please briefly describe your idea/company.
9
. Website URL (if applicable):
Website URL (if applicable):
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10
. Description of investment needed and why someone would invest:
Description of investment needed and why someone would invest:
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11
. What is your Value Proposition?
What is your Value Proposition?
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12
. Explain the opportunity, pain, or problem in the market your business will address:
Explain the opportunity, pain, or problem in the market your business will address:
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13
. Who is your most likely customer? Describe them in detail:
Who is your most likely customer? Describe them in detail:
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14
. How will you make money?
How will you make money?
*
15
. Have you registered for the National CEO Conference?
Have you registered for the National CEO Conference?
Yes
No
No, but I'm planning to soon.
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