APPLICATION

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Company Name*

Company Website*

Which category best applies to your company*

In three or fewer sentences, please tell us why you started your company.*

What stage is your company in right now?*

How much revenue have you made in the past year (in USD)?*

How much money have you raised so far and from whom?*

List any co-founders and/or partners you may have*

Describe your product in one sentence.*

If you have a demo video, include URL here

Name*

First Last

Email*

Phone*

Were you referred by anybody? (Please let us know who)*

I understand that the data I am submitting will be used to provide me with the above-described products and/or services and communications in connection therewith.*

I confirm that all information provided in the form above is truthful and I have never been convicted of a crime/fraud and I consent the above-described data and its use by Crank Enterprises.