StartUP Columbus Incubator Program Application

Thank you for applying to be a part of our Incubator Program at StartUP Columbus! We have outlined what to expect below.

The Application Process is as follows:

Applicant submits incubator application to StartUP Columbus
StartUP Columbus reviews application
A meeting is set to build rapport, discuss findings, and ask any questions
A background check is conducted for the applicant
Application is submitted for approval to the Director of StartUP Columbus
After approval is communicated and accepted, new client and director establish short- and long-term goals for relationship
Client moves into incubator

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* 1. Legal First Name:

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* 2. Legal Middle Name:

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* 3. Legal Last Name:

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* 4. Please select your age:

Under 18

18-24

25-34

35-44

45-54

55-64

65+

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* 5. Please select your gender:

Female

Male

Transgender

Gender Non-conforming/Non-binary

None of the above

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* 6. Please select your race/ethnicity:

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

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* 7. Do you identify as any of the following communities of interests?

Founder of a social enterprise (maximizing both social images and profit)

LGBTQIA+

Military service

New American citizen or immigrant

Person of Color

None of the above

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* 8. Are you a current or former member of the U.S. Military or National Guard?

Yes

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* 9. What is your annual income?

Under $15,000

Between $15,000 and $29,999

Between $30,000 and $49,999

Between $50,000 and $74,999

Between $75,000 and $99,999

Between $100,000 and $150,000

Over $150,000

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* 10. What is your Social Security Number?

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* 11. Please upload a photo of your government issued identification card (e.g. driver's license, passport, or visa):

PDF, DOC, DOCX, PNG, JPG, JPEG, GIF file types only.

Choose File

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* 12. Email:

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* 13. Business Name:

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* 14. In 40 words or less, please describe your business:

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* 15. Type of Business:

Business: a venture that exists to provide a product, software, or service that people are willing to buy

Cause: a venture that exists to provide sustainable impactful solutions to social, cultural, and environmental problems

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* 16. Is your business registered?

Yes

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* 17. If so, what state is your business registered in?

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* 18. What is your primary need for the Incubator Space at StartUP Columbus? (e.g. office space, conferencing area, etc.)

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* 19. How many members of your team will use StartUP Columbus Incubator regularly (at least one day per week)?

Just myself

2-3

More than 3

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* 20. Do you plan to use the StartUP Columbus Incubator address for your certificate of Occupancy?

Yes

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* 21. Have you visited or toured StartUP Columbus?

Yes

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* 22. Have you completed the CO.STARTERS program? (Not a requirement)

Yes

StartUP Columbus Incubator Program Application

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* 1. Legal First Name:

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* 2. Legal Middle Name:

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* 3. Legal Last Name:

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* 4. Please select your age:

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* 5. Please select your gender:

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* 6. Please select your race/ethnicity:

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* 7. Do you identify as any of the following communities of interests?

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* 8. Are you a current or former member of the U.S. Military or National Guard?

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* 9. What is your annual income?

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* 10. What is your Social Security Number?

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* 11. Please upload a photo of your government issued identification card (e.g. driver's license, passport, or visa):

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* 12. Email:

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* 13. Business Name:

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* 14. In 40 words or less, please describe your business:

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* 15. Type of Business:

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* 16. Is your business registered?

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* 17. If so, what state is your business registered in?

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* 18. What is your primary need for the Incubator Space at StartUP Columbus? (e.g. office space, conferencing area, etc.)

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* 19. How many members of your team will use StartUP Columbus Incubator regularly (at least one day per week)?

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* 20. Do you plan to use the StartUP Columbus Incubator address for your certificate of Occupancy?

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* 21. Have you visited or toured StartUP Columbus?

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* 22. Have you completed the CO.STARTERS program? (Not a requirement)

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* 23. Please print your name below as a digital signature to complete this application.