Primary Evolve Intake Form

Name*

First NameLast Name

Email*

example@example.com

(Optional) LinkedIn Page Link

(Optional) Phone Number

Please enter a valid phone number.

Country of Birth*

Current Country of Residence*

Are you interested in the Genesis Startup Visa Program?*

*For more information, please see - SUV Information.

**Formal proof is not required for this initial application but will be mandatory at a later stage. You can find more details here - Language Proficiency Requirement.

We look forward to receiving your application for Evolve.

Province of Residence*

Are you legally entitled to work in Canada*

YesNo

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.

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*