Please fill this out completely.  You will need to fill it out in one sitting, so you may want to copy the questions, fill them out offline, and then copy your answers into the form.  
We will have one hour info sessions on the following dates:
Friday, Nov 5th, 11am CT
Thursday, Nov 18th, 9am CT
Wednesday, Dec 1st, Noon CT
You can register here: https://www.c200.org/champion
If you have any questions, please contact us at champion@c200.org.
Thank you!

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* 1. Applicant name:

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* 2. Business name:

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* 3. Business address:

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* 4. Business contact information:

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* 5. First name of applicant:

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* 6. Last name of applicant:

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* 7. Your contact information:

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* 10. Please give us a brief description of your business:

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* 11. Ownership information:

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* 12. If you have other co-owners, list their full names and percentage ownership:

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* 13. Do you have a partnership agreement in place with the co-owners?

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* 14. Have you participated in any other accelerators to date?

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* 15. If yes, which ones and when:

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* 16. Why are you interested in joining C200’s CHAMPION Program? (1500 characters or less)

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* 17. Describe your business’s product or service. (500 characters or less)

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* 18. What problem does your product or service solve and what inspired you to solve that problem? (1000 characters or less)

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* 19. What is your business's annual revenue?  Tax documents and P&L statements may be requested.

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* 20. How many years has your business been operating?

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* 21. How many employees do you currently have?

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* 22. Have you received any outside funding to date? If so, how much and from what sources? (Family and friends, angel, venture capital, bank loan, grant, pitch competition/awards, etc.)

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* 23. What is the vision for your company in 5-10 years?  (Acquisition strategy, sustainable growth, global expansion, etc.) (2000 characters or less)

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* 24. Why are you the right candidate for this program? (2000 characters or less)

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* 25. C200’s CHAMPION Program meets virtually every Tuesday 5:00pm - 6:30pm CT and Thursday 11:00am - Noon CT for 12 weeks beginning February 1, 2022.  Classes end May 5, 2022 and are conducted by Babson's WIN Global.  From May through December, the group meets virtually every month on the second Tuesday of the month from 5:00pm - 7:00pm CT. Your attendance at these meetings is expected. Other activities will be announced as they become available.

Participants are expected to attend program activities, contribute to the community, be transparent about their business progress, meet with their assigned mentors, and achieve key milestones. If circumstances arise that inhibit your ability to actively engage with the program, it is your responsibility to inform the leadership team right away.

You will be contacted after the close of the application process. For those asked to move to the next round, we will schedule 30 minute interviews. Applicants will be notified before the end of the year if they are accepted. They will be expected to be able to attend classes beginning in January.

I understand the requirements of the CHAMPION program and agree.

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* 26. Please upload your executive summary here.  It should be no longer than two pages.  The content is more important than the presentation; word documents are fine. 
Please include the following sections:
Description of Business
Competitive Advantage
Industry Overview (Briefly describe the industry)
Description of Market Opportunity & Target Market
(How big is the problem you are solving? What is your total addressable market? Who is your target market?)
Business Model and Economics (How do you make money? How do you charge for your product or service (i.e. one-time fee, subscription model, etc.)? How much?)
Team (Who is on your team? Who is on your board of advisors, if applicable?)
Financial Snapshot (Provide 1-3-year financials snapshot)

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