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SoundAffects Application Form
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Contact Information
Name of Organization
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Mailing Address
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Website URL
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Primary Contact Person(s)
Name
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Email
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Media & Outreach
Please attach a still photo that will serve as the "face page" of your campaign. Photo resolutions and dimensions must be: 250x200 pixels @ 300 dpi.
Accepted file types: jpg, jpeg, gif, png, pdf, tif, bmp.
Campaign Video URL
Company Pitch Deck (PowerPoint or PDF)
Accepted file types: ppt, pptx, pptm, pdf.
Social Media Handles
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Campaign Overview
Summary
*
Please provide a summary that adequately describes your technology in layman's terms. Please limit to 30 words.
Fundraising Goal ($)
*
Please enter an exact monetary value. Submissions without a clear fundraising goal will not be accepted.
Campaign Questions
Please limit each answer to 200 words. Please write your responses clearly, using non-technical jargon.
1. What is the critical gap in cancer treatment that you are addressing?
*
2. What is the key product development milestone you seek to fund?
*
3. How will funds be used? Please provide breakdown of major budget items.
*
4-A. What key resources have/will you acquire to facilitate the accomplishment of the above product development milestone? (i.e. current funding sources, strategic partnerships, talent, infrastructure)
*
4-B. If successful, how would you leverage funds raised through our portal to access key funding from other sources, (i.e. matching grants/investments).
*
5. If your Technology were to disappear in the “Valley of Death” funding bottleneck how might this impact society?
*
Your Team
List your companies key human resources and provide a title and short bio of each.
Team Member 1
Team Member 2
Team Member 3
Team Member 4
Team Member 5
Team Member 6
Team Member 7
Team Member 8
Team Member 9
Team Member 10
Please click here to add additional team members if needed:
Add Team Member
Publications
Please provide the URL’s to following relevant publications:
Blog Articles:
Blog 2:
Blog 3:
Blog 4:
Blog 5:
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Media Interviews:
Media Interview 2:
Media Interview 3:
Media Interview 4:
Media Interview 5:
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Articles published in Newspapers/Magazines:
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Newspaper 3:
Newspaper 4:
Newspaper 5:
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Press Releases:
Press Release 2:
Press Release 3:
Press Release 4:
Press Release 5:
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White Papers:
White Paper 2:
White Paper 3:
White Paper 4:
White Paper 5:
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Articles published in Scientific/Medical Journals:
Journal 2:
Journal 3:
Journal 4:
Journal 5:
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Published patents:
Patent 2:
Patent 3:
Patent 4:
Patent 5:
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