ScaleUp Accelerator Registration Form

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Name* This field is required.
First Name
Last Name
2
Contact Info* This field is required.
Email, example@example.com
Please enter your phone
3
Email* This field is required.
example@example.com
4
Phone Number* This field is required.
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Company Information* This field is required.
Company Name (Sdn.Bhd./Bhd./Enterprise/LTD etc.)
Company Registration Number
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Company Name* This field is required.
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Company Registration Number* This field is required.
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Date of Company Incorporation* This field is required.
Date
Year
Month
Day
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Industry* This field is required.Please select an industry most relevant to you.
Agriculture
Automotive
Construction/Building
Consumer Staples
Cybersecurity
Dronetech
E-commerce
Education
Environment & Renewables
Food & Beverage
Finance / Fintech
General Business Solution/Software
General IT Solution
Health & Wellness
Human Resource
Marketing/Media/Creative Services
Manufacturing
Property
Sports
Transportation/Logistics
Travel/Tourism
Other
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Company Description* This field is required.Please describe what your company does.
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Marketing Information* This field is required.Fill in "NA" if not applicable.
Company Website
Facebook
Instagram
LinkedIn
Twitter
Brand Name, IF you are marketing your product under a different name
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Company Website* This field is required.Do state 'NA' if not applicable.
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Facebook URL* This field is required.
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Instagram URL* This field is required.
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LinkedIn URL* This field is required.
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Twitter URL* This field is required.
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Which of these scenarios most accurately describes your situation?* This field is required.
I am currently developing a new product idea
I am currently testing my product in the market
I have a product with a few early paying customers
I have a product with consistent customer growth
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When do you expect your product to be launched?Months from today
Launch product in 0-3 months
Launch product in 3-6 months
Launch product in 6-9 months
Launch product in in 9-12 months
Launch product in >12 months
I don't know
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Describe your idea or product, what it does for whom, and its core features.* This field is required.In 200 words or less, give us an idea of what your product is all about and what's unique about its core features, let us know if its marketed under different brand name. You can even attach links to your product demos too!
0/200
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What type of business are you?* This field is required.You may select more than one business model
B2B
B2C
B2B2C
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B2B customers* This field is required.
Number of business customers
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B2C customers* This field is required.
Number of free users
Number of paying users
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B2B2C customers* This field is required.
Number of business customers
Number of individual customers
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What was your last 12 months (LTM) revenue to date ? (In USD)* This field is required.
Not generating revenue
Less than 10000
Between 10001 to 50000
Between 50001 to 150000
Between 150001 to 250000
More than 250000
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What percentage of this revenue can be ascribed to the product you described before?* This field is required.In %
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When do you expect to start generating revenue for your product?
Start generating revenue in 0-3 months
Start generating revenue in 3-6 months
Start generating revenue in 6-9 months
Start generating revenue in 9-12 months
Start generating revenue in >12 months
I don't know
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What is your estimated projected twelve months revenue from now? (in USD)
I don't know
Less than 10000
Between 10001 to 50000
Between 50001 to 150000
Between 150001 to 250000
More than 250000
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What is your main revenue model for your product?* This field is required.
Advertising Fees
Freemium
Licensing Fees
One - Off Sales
Subscription Fees
Transaction Fees
I don't know yet
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What are your current challenges?* This field is required.You may select more than one, or tell us your specific challenges
Market Access
Funding
Legal Support
Sales and Marketing
Development / Tech Team
Business Strategy
Go-to-Market Planning
Other
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Company Capital* This field is required.What is the current shareholding structure of your company? The following should add up to 100%.
Founder
Angels
Institutional (eg. VC, Corporate)
ECF (Crowdfunding)
Ownership (%)
Row 0, Column 0
Row 0, Column 1
Row 0, Column 2
Row 0, Column 3
Ownership (%)
Founder
Row 0, Column 0
Angels
Row 0, Column 1
Institutional (eg. VC, Corporate)
Row 0, Column 2
ECF (Crowdfunding)
Row 0, Column 3
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Percentages should add up to 100%
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Calculation
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Are you looking to raise your next VC round?* This field is required.
Yes I am looking to raise my next VC round
No I am not looking for funding
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What amount are you looking for your next round? (USD)Based on your best estimate
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When do you plan to close your next round?
Close round in 0-3 Months
Close round in 4-6 Months
Close round in 7-9 Months
Close round in 10-12 Months
Close round in >12 Months
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As the Founder, tell us a bit about yourself* This field is required.Who are you and why have you started this venture. You may provide us a link to a video, if writing is not your thing!
0/0
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Founding Team* This field is required.Let us know a bit more about you and your founding team
Founder / Co-Founder Name
Company Position eg. CEO, CTO
LinkedIn URL
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Row 0, Column 0
Row 0, Column 1
Row 0, Column 2
2
Row 1, Column 0
Row 1, Column 1
Row 1, Column 2
3
Row 2, Column 0
Row 2, Column 1
Row 2, Column 2
4
Row 3, Column 0
Row 3, Column 1
Row 3, Column 2
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Row 4, Column 0
Row 4, Column 1
Row 4, Column 2
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2
3
4
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Founder / Co-Founder Name
Row 0, Column 0
Company Position eg. CEO, CTO
Row 0, Column 1
LinkedIn URL
Row 0, Column 2
Founder / Co-Founder Name
Row 1, Column 0
Company Position eg. CEO, CTO
Row 1, Column 1
LinkedIn URL
Row 1, Column 2
Founder / Co-Founder Name
Row 2, Column 0
Company Position eg. CEO, CTO
Row 2, Column 1
LinkedIn URL
Row 2, Column 2
Founder / Co-Founder Name
Row 3, Column 0
Company Position eg. CEO, CTO
Row 3, Column 1
LinkedIn URL
Row 3, Column 2
Founder / Co-Founder Name
Row 4, Column 0
Company Position eg. CEO, CTO
Row 4, Column 1
LinkedIn URL
Row 4, Column 2
1 of 5
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Your Team Size* This field is required.How many people are in your company on a full-time basis
1-5
6-10
11-15
16-20
>20
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Are you currently part of or graduated from an Incubator/Accelerator?* This field is required.
Yes I am currently part of or graduated from and Incubator/Accelerator
No I have not joined any Incubator/Accelerator program
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Please list which Incubator(s) / Accelerator(s)
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Upload Your Pitch DeckOptional, but encouraged :)
Drag and drop files here
Select files to upload
Max. file size: 10.6MB
Cancelof
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Please provided us a URL to a video introducing the founder(s) of the company. No longer that a minute long.
eg. Tell us why you started this business!
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What is your expectation of ScaleUp Malaysia?* This field is required.You may select more than one.
I need funding to develop my product or expand my business
I need help with business strategy
I want to gain more media exposure through ScaleUp Malaysia
I need assistance from ScaleUp Malaysia to access Southeast Asia
I want to reorganise my management team and perform better hiring
Other
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How did you find us?* This field is required.
Social Media
Website/Search Engine
Email
Recommended by a Partner in ScaleUp
Recommended by ScaleUp Alumni or Affiliate organisation
Recommended by Other Accelerator/Investor
I attended an event and came across ScaleUp
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Who recommended you?
Doc Siva
Renuka Sena
Aaron Sarma
Andre Sequerah
Shan Li Tay
Xelia Tong
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Please let us know who recommended you
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