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Daiichi Sankyo VIP Forum Application

1:1 Sessions will be held with representatives from Daiichi Sankyo on October 28t. LSW EVS will reach out to you by September 8th if you are selected for a meeting. Please also email a non-confidential slide deck to aylin@lifesciencewa.org
1.First and Last Name(Required.)
2.Professional Title (Required.)
3.Phone (Required.)
4.Email Address (Required.)
5.Company name (Required.)
6.Street address (Required.)
7.City (Required.)
8.State (Required.)
9.Website (Required.)
10.Year incorporation/ formation
11.Number of employees
12.Subsector (select one)(Required.)
13.Technology Classification (select all that apply)(Required.)
14.Area of focus (select all that apply)(Required.)
15.Management team and Board (200 word max)
16.Target / Underlying Biology / MOA / Modality(Required.)
17.Disease area(s) / Disease(s) targeted(Required.)
18.Description of your technology (200 word max) (Required.)
19.Development Stage(Required.)
20.Key partnership objectives (200 word max) (Required.)
21.Current partnerships and/or alliances (200 word max)(Required.)
22.Key next steps in development(Required.)
23.Are you generating revenue?
24.Recent milestones and next steps (200 word max)(Required.)
25.Status of Intellectual Property(Required.)
26.Ownership (Required.)
27.Capital raised to date and funding history (Required.)
28.Non-confidential slide deck(Required.)
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