Primary Evolve Intake Form

Name*

First NameLast Name
Email*
example@example.com
(Optional) Phone Number
Please enter a valid phone number.
(Optional) LinkedIn Page Link
Country of Birth*
Current Country of Residence*
Province of Residence*
Are you legally entitled to work in Canada*

YesNo
Please See Below

We are no longer accepting applications for the Startup Visa Program from applicants outside of Canada. However, we do encourage applicants within Canada on temporary immigration status to apply if they meet the eligibility criteria.
Do you plan to operate this business in NL*

YesNo
What is your plan and timeline to operate in NL?*
City of Residence*
Company Name*
If unknown, please use TBA
Describe the problem your business is solving & why you want to solve this problem*
In detail, describe your business idea and the technology involved*
In detail, describe any traction/validation you have made to date? (Ex: Potential customer interviews, waitlists, testimonials, users, pre-orders, sales, etc.)*
(Optional) Feel free to include a pitch deck, business plan, lean canvas, resume, etc.

Cancelof
Are you interested in in-person or virtual Evolve?*

In-person at Signal Hill CampusVirtually, by Teams/ZoomVirtually, self guided with occasional Teams/ZoomI’m looking for information on other Genesis programs
Gender*
Do you identify as Black, Indigenous, or a person of colour?
Community Identification (please hold "shift" to select more than one option)
Are you a student?*

YesNo
What school do you attend*

Memorial UniversityCollege of the North AtlanticOther post secondary institution
Were you a part of the Mun Centre for Entrepreneurship?*

YesNo
Are you an alumni of a post secondary institution*

Yes, Memorial UniversityYes, College of the North AtlanticYes, at another post secondary institutionNo
Field/Program of Study*

Please See Below