1:1 Sessions will be held with representatives from Otsuka on March 16th. LSWI will reach out to you by March 3rd if you are selected for a meeting.

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* 1. First and Last Name

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* 2. Professional Title

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* 3. Phone

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* 4. Email Address

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* 5. Company name

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* 6. Street address

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* 7. City

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* 8. State

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* 9. Website

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* 10. Year incorporation/ formation

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* 11. Number of employees

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* 12. Subsector (select one)

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* 13. Technology Classification (select all that apply)

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* 14. Area of focus (select all that apply)

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* 15. Management team and Board (200 word max)

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* 16. Target / Underlying Biology / MOA / Modality

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* 17. Disease area(s) / Disease(s) targeted

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* 18. Description of your technology (200 word max)

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* 19. Development Stage

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* 20. Key partnership objectives (200 word max)

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* 21. Current partnerships and/or alliances (200 word max)

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* 22. Key next steps in development

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* 23. Are you generating revenue?

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* 24. Recent milestones and next steps (200 word max)

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* 25. Status of Intellectual Property

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* 26. Ownership

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* 27. Capital raised to date and funding history

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