Incubation Form - Gsss Incubation

Application

Home | Application

Application Form for the post of CEO/Incubation Manager/Incubation Associate/Accounts and Finance officer for DST-iTBI -GSSSTBIF@GSSSIETW campus, KRS Road, Metagalli,Mysore

To Apply Fill The Form Below

Name of the Applicant -1

Date of Birth *

Name of the Applicant -2

Date of Birth *

Name of the Company

Sector of the Startup

Date of Company Registration

Startup Karnataka Registered
YesNo

Women led Startup
YesNo

Patents filed (if any):
YesNo

Social Media Handling:

Website:

Logo of your company

Founder details:

Photo :

Other Top Management details

Permanent Address:

Educational Qualification: (from highest qualification to l0th grade) (Details of Board/Institution/University/Area of Specialization/Year of graduation)

Sl.No	Board/Institution/University	Area of Specialization	Year of graduation

Professional Experience:

Company Details:

Nature of Business:

Briefly describe your business model (Attach separate sheet, if required):

How long have you been in business?
Less than a yearLess than 5 yearsMore than 5 yrs

Legal entity sought:
ProprietorshipPartnershipPvt LtdLLP etc

Service expected from DST i-TBI GSSSTBIF:

Details of your Team:

Lead members of the team:

Number of employees that will be resident (if applicable):

Write a one page State of purpose on why you want to become an entrepreneur:

Applicant’s or team members’ previous business experience (if any), the nature and years of expertise:
(Individual resumes of each member may also be attached)

Any past experience which is going to help in this new venture:

Please submit an estimated and identified seed funding needs/source (if any):

Specify if there is any requirement for machinery or capital item for starting the venture:

Please submit a brief business plan for the company as a separate document:

Briefly describe the methods and results of any market survey conducted so far:

Describe your target market and its potential:

Product/Service Details:

Please give a brief outline of product/service details

Any projected export market for your products / services (Yes/No) please specify nation/region

Any research or survey conducted to validate the assumption (specify if any):

Any requirement to go global for producing the products or offering your services (Yes/No)

You learnt about DST i-TBI GSSSTBIF through newspaper/magazine/internet/blogs/friends/any other

References: (Give two references here, verification will be done after completion of the selection process)

Declaration:

The information that I/we have provided is correct. I have read and understood and accepted the terms and conditions set forth in the disclaimer in the beginning of this application.

Applicant’s Signature

Date