2018 Pitching Den Competition. DEADLINE EXTENDED TO 12 JULY 2018 Survey

Company Name (trading name)

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* 1. Company Name (trading name)

Company Details

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* 2. Company Details

Physical Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Country

Social Media Details

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* 3. Social Media Details

Website Address

Twitter address

Facebook address

LinkedIn Address

Contact Details of Lead Entrepreneur

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* 4. Contact Details of Lead Entrepreneur

First Name

Last Name

Email Address

Phone Number

Tell us about your Product / Business in no more than 150 words. Make sure your answer is clear and concise and sets you apart from other applicants.

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* 5. Tell us about your Product / Business in no more than 150 words. Make sure your answer is clear and concise and sets you apart from other applicants.

Select the tract in which your product / business falls.

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* 6. Select the tract in which your product / business falls.

BioTech

FinTech

EduTech

AgriTech

Cities of the Future

Space/Big Data/Artificial Intelligence/Robotics

Other (please specify)

What would you like to pitch?

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* 7. What would you like to pitch?

Your Company as a whole

An Idea

A specific product / service / invention / solution)

Describe your target market in no more than 100 words

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* 8. Describe your target market in no more than 100 words

Describe your competitors (maximum 50 words)

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* 9. Describe your competitors (maximum 50 words)

What is the biggest challenge you face in growing your business / commercialising your product?

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* 10. What is the biggest challenge you face in growing your business / commercialising your product?

Select the option that describes your product maturity the best.

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* 11. Select the option that describes your product maturity the best.

Idea / Concept

Pre-commercialised (i.e. you have a prototype but it is not yet commercially available)

Commercialised (your product / service is available in the market)

Ready to scale

Describe your team and organisational structure

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* 12. Describe your team and organisational structure

Do you have IP protection?

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* 13. Do you have IP protection?

Yes

Type of IP

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* 14. Type of IP

Patent

Design registration

Trademark

Trade secret

No IP Protection at this stage

Other (please specify)

If protected, please provide relevant registration number(s)

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* 15. If protected, please provide relevant registration number(s)

Which of the following options are applicable to your organisation?

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* 16. Which of the following options are applicable to your organisation?

Record a turnover of between R 0 and R 2 million per annum currently

Record a turnover of between R 2 million and R 5 million per annum currently

Record a turnover of between R 5 million and R 10 million per annum currently

Record a turnover of between R 10 and R50 million per annum currently

Record a turnover of between R 50 and R100 million per annum currently

Record a turnover of between R 100 and R500 million per annum currently

Record a turnover of more than R25 million per annum currently or within the next 24 months

Demonstrate high growth potential or increasing market share

Demonstrate scalability

Be close to achieving break-even or profitability

Have national or international expansion plans with a high level of commitment by your shareholders and management team

Start-up company

Pre-commercialisation

None of these options above are applicable to my company

How many years has the business been in operation?

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* 17. How many years has the business been in operation?

How many shareholders does the company have?

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* 18. How many shareholders does the company have?

How will your business look 5 years from now? (400 words)*

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* 1. Company Name (trading name)

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* 2. Company Details

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* 3. Social Media Details

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* 4. Contact Details of Lead Entrepreneur

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* 5. Tell us about your Product / Business in no more than 150 words. Make sure your answer is clear and concise and sets you apart from other applicants.

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* 6. Select the tract in which your product / business falls.

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* 7. What would you like to pitch?

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* 8. Describe your target market in no more than 100 words﻿

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* 9. Describe your competitors (maximum 50 words)

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* 10. What is the biggest challenge you face in growing your business / commercialising your product?

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* 11. Select the option that describes your product maturity the best.

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* 12. Describe your team and organisational structure

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* 13. Do you have IP protection?

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* 14. Type of IP

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* 15. If protected, please provide relevant registration number(s)

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* 16. Which of the following options are applicable to your organisation?

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* 17. How many years has the business been in operation?

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* 18. How many shareholders does the company have?

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* 19. How will your business look 5 years from now? (400 words)*

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* 20. Where did you first hear about the 2018 SA Innovation Summit Competitions?

* 8. Describe your target market in no more than 100 words