Virgin StartUp Collective Impact: Application Form

First Name

Last Name

Email Address

Phone Number

Gender

Other

Company Name

Your CRN if your business is registered in the UK.

Your position in company

Companies House Registration Number

Company Website

Founder/CEO LinkedIn

What country is your company based in?

What city is your company based in?

Please note that we can only accept UK applications.

Around how much would you be looking to raise?

(Please enter numbers only)

Are you eligible for SEIS or EIS?

YesNoDon't know

Is your product or service already live?

YesNoOther

Other(please specify)

Short description of your business (up to 250 words)

Tell us about your team (up to 100 words)

How is your business creating a positive impact in the world? (Up to 250 words)

What's your main reason for applying to the programme?

How much investment have you raised to date?

(Please enter numbers only)

What was the source of the investment?

Please tell us about your traction or validation of your product or service to date, include any metrics, data and numbers you may have.

What's your monthly revenue, if applicable?

(Please enter numbers only)

Have you joined other business accelerator or similar? if so, which one(s)?

How did you hear about the programme or were you referred?

Please specify

What industry best describes your business

Other

Please upload your pitch deck

I understand there is a cost for this programme if I am accepted of £2750 + VAT.

I agree to the collection, use and storage of my personal information as described in the Privacy Notice

I would like to sign up to the mailing list to receive marketing communications from Virgin StartUp

By submitting your application you (i) agree to receive communications from Virgin Startup about this programme; (ii) agree and acknowledge that all data and confidential information submitted may be shared by Virgin StartUp with third parties such as judges and potential investors, for the purposes of the programme (iii) agree to the terms and conditions of the programme.

Scaling Programme ID

Source

Tech based	B2B	B2C	B2B2C
Marketplace	AI/Machine Learning	SAAS	Sustainability
Circular economy	Impact	Blockchain	Web 3
Crypto	AR/VR	Robotics	B Corp