XLH Pre-Accelerator Registration - xlerator

XLerateHealth Pre-Accelerator Registration

Name *

First

Last

Email *

Address

Address Line 1

Address Line 2

City

State

Zip Code

Cell Phone *

Website / URL

What are your expectations of the Pre-Accelerator program? *

Business information; Please tell us about your business. *

Stage (i.e., concept or established)

Company Name

Business Address

Address Line 1

Address Line 2

City

State

Zip Code

Business Website

What type of business is it?

What is your primary industry?

Have you taken steps to protect your intellectual property? (whether it was assigned by an owner or obtained in another way)

Yes
No

Describe the key advantages of the technology

How did you hear about / who referred you to this program?

Website