Name
First Name
Last Name
What are your pronouns? (Optional)
Job Title
Phone Number
Please enter a valid phone number.
Email
example@example.com
Company Name
Size of Team
Are you the Founder?
Yes
No
Website URL:
When was your company founded?
Company location (US-only):
What time zone are you in?
How much funding have you raised in investments, in grants, donations, etc.?
Are you a non-profit organization or a for-profit organization?
Non-Profit
For-Profit
If you are a for-profit, where are you in your fundraising journey (seed, Series A, etc.)?
Friends and Family
Seed
Series A
Series B
Series C
Other
What is your company’s mission and how does it foster equitable engagement with the disability community?
The Participation of People with Disabilities
How are people with disabilities integrated into your organization? Select all that apply:
Founded by someone with a disability
Led by someone with a disability
People with disabilities on board
People with disabilities among management/ leadership team
People with disabilities within team/workforce
Ongoing consultation with a disability-led organization or agency
People with disabilities advise and test product or service
Founders/ leaders have family member with a disability
Comment (Optional):
Are you currently working with any disability groups, organizations or consultancy groups? If so, who, for how long, and how frequently do you engage them?
Do any members of your leadership team identify as any of the following? Select all that apply:
BIPOC (Black, Indigenous, People of Color)
Women
LGBTQIA+ (lesbian, gay, bisexual, transgender, queer, intersex, or asexual)
Veteran
Understanding the Need
What is the primary disability your solution is positioned to support? Select all that apply:
Mobility/Physical
Sensory Processing
Vision
Hearing
Speech
Cognitive/Learning
Developmental/Intellectual
Psychological/Mental Health
Chronic Illness
Other
Describe the need your solution aims to address for those with disabilities. Why is this an important need to address? Describe the scope/magnitude of this need within a U.S. context.
What pain point(s) or barrier(s) experienced by a person with a disability does your solution address?
Mobility
Communication
Education
Social & Economic Inclusion
Independent Living
Healthcare & Access to Selfcare
Other
Disability Innovation Solution
Describe your solution and how it uniquely unlocks opportunities for people with disabilities. Discuss the potential impact for your target audience.
In what ways have you engaged people with disabilities to validate your solution?
Does your solution provide benefits to people without a disability, as a way to expand broader usability beyond the disability community?
Technology Fit
Describe how your product is different from currently available technology solutions.
At what stage of development is your proposed solution? Do you have an MVP (minimum viable product/prototype/alpha/beta/in-market)?
Is your product or service and customer-facing information accessible according to globally accepted guidelines (e.g., WCAG 2.1)?
Yes
No
Which next-generation technologies does your solution currently utilize or anticipate utilizing in the future?
5G
Edge Computing
Data Science
Speech and/or Image Recognition
Artificial Intelligence
Extended Reality
Internet of Things
Other
Are you the sole owner of your technology’s IP?
Yes
No
Other
How can you leverage Verizon technology to advance your solution?
How is your technology designed to be adaptable and evolve as future innovations in hardware and software are developed and adopted by the market?
Business Model and Scaling
Who is the primary customer for your solution? Is this different from the end user?
Describe your market focus? [location, demographics, key customer base, business to consumer (B2C) or business to business (B2B), or public institution, etc.]
Describe your financial model? How do you make money? What are your major expenses?
What is your growth strategy? How would $50k help you scale?
Does your business plan anticipate an eventual sale, exit, acquisition, merger?
Team Fit
List and describe your leadership team (name, title, short bio, links to online resources such as LinkedIn)
Why is your team uniquely qualified to address this need?
If accepted into the program, who from your leadership team will participate in the program?
What do you hope to gain from participating in this accelerator?
Accessibility Accommodations
For the next round, we will be interviewing the selected startups via video chat. Since we would like to make sure the experience is accessible for all participants, if you were selected what accommodations would you need, if any?
Notes
Our partners XR Access, an organization dedicated to ensuring the accessibility of virtual, augmented, and mixed reality for people with disabilities have great resources and additional opportunities. Would you like to opt in to communication from them?
Yes
No
This website and form are managed by Alley in partnership with Verizon. By submitting this form you agree to this site's cookie use, Verizon's privacy policy, as well as the Terms & Conditions of this program. You agree to communication from both Alley and Verizon's team regarding your application and upcoming opportunities for this program.
*
I Agree
Save
Submit
Kara Scoring
1
2
3
4
Understanding of the Problem
Technology Fit
Disability Innovation
Business Model & Market Traction
Involvement of People with Disabilities
Carley Scoring
1
2
3
4
Understanding of the Problem
Technology Fit
Disability Innovation
Business Model & Market Traction
Involvement of People with Disabilities
Curtis Scoring
1
2
3
4
Understanding of the Problem
Technology Fit
Disability Innovation
Business Model & Market Traction
Involvement of People with Disabilities
Understanding the Problem
Technology Fit
Disability Innovation
Business Model
Involvement from Community
Should be Empty: