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Company General Information

Company Legal Name*

First Name*

Last Name*

Title*

Phone*

Mobile

Email*

Website

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Year Founded*

Current Stage*

4-digit NAICS code*

Legal Structure*

Number of Full-Time Employees*

Please count any part-time employees as .5 FTE’s

BUSINESS DETAILS — Problem & Market

What customer problem do you solve, and who feels it most?*

Name the customer persona, their pain, and how they cope today.

How big is this problem for your customer? (quantify if possible)*

e.g., “$X lost per year,” “Y hours wasted per week,” “Z% error rate”

How many substantive customer discovery conversations have you had?*

In those conversations, how often is this problem a top-3 priority?

Estimate your Total Addressable Market (TAM) in US$ and briefly explain how you calculated it*

e.g., “5,000 mid-market hospitals × $50K/yr = $250M SAM (bottom-up from AHA data)”

BUSINESS DETAILS — Solution & Differentiation

Describe your solution in 2-3 sentences.*

What does it do? How does the customer use it?

Name 2 competitors and one reason a buyer picks you*

Include “do nothing / manual process” if that is the real competitor

What is better about your solution, and what will be hard to copy in 12 months?*

IP, proprietary data, switching costs, regulatory moat, network effects

Is your product in market today?*

Does your business have defensible IP or technical differentiation?*

Patents, trade secrets, proprietary data, regulatory moat

If you are pursuing a regulatory pathway, what pathway are you pursuing?

BUSINESS DETAILS — Traction & Validation

Strongest evidence customers will pay*

Signed LOI(s)

Paid pilot(s)

Paying customers

Design partners

Grant(s) tied to customer need

Pre-orders/waitlist

None yet

Number of paying customers

Trailing 12-month revenue band*

How do you make money (business model)?*

Gross margin

BUSINESS DETAILS — Team & Execution

Founder 1 LinkedIn URL*

Founder 2 LinkedIn URL

BUSINESS DETAILS — Capital & Milestones

What round of fundraising are you in?*

How much are you raising this round?

How much have you raised so far (this round)?

Investment instrument

Terms (cap / discount / valuation)

e.g., “$8M cap, no discount” or “$6M pre-money”

Capital raised to date (all sources)*

Sources of prior capital*

Venture Capital

Angel

SBIR/STTR

Bank/Lender

MEDC

Founder/Insider

Corporate/University/Foundation

Other

Monthly burn rate

Current cash balance/Runway (months)

e.g., “$45K / ~4 months”

If given this capital today, how would you allocate it? (3-4 uses)*

e.g., “40% engineering hires, 25% sales, 20% product dev, 15% ops”

What specific milestones will this capital fund in next 12–18 months?*

3-5 measurable milestones (e.g., reach TRL 5, close 10 customers, hire CTO)

Michigan Presence & Eligibility

Is your company headquartered in Michigan?*

Percent of current team physically based in Michigan*

Where will you hire your next 5–10 employees?

e.g. MI city/region: ___ (# roles) | Outside MI: ___ (# roles)

BUSINESS DETAILS — Attachments

Pitch Deck*

Ensure deck covers: problem, solution, market, product, traction, team, competition, financials, ask

Drop files here or

Accepted file types: pdf, Max. file size: 20 MB, Max. files: 1.

Financial Projections*

3-5 year projections: revenue, expenses, cash flow, hiring plan

Drop files here or

Accepted file types: pdf, Max. file size: 20 MB, Max. files: 1.

P&L / Income Statement

If revenue-stage; current YTD or trailing 12 months

Drop files here or

Accepted file types: pdf, Max. file size: 20 MB, Max. files: 10.

Additional Documents

Executive summary, LOIs, patent filings, demo video, customer testimonials, etc.

Drop files here or

Accepted file types: pdf, Max. file size: 20 MB, Max. files: 10.

Company General Information

BUSINESS DETAILS — Problem & Market

BUSINESS DETAILS — Solution & Differentiation

BUSINESS DETAILS — Traction & Validation

BUSINESS DETAILS — Team & Execution

BUSINESS DETAILS — Capital & Milestones

Michigan Presence & Eligibility

BUSINESS DETAILS — Attachments

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