Recruitment Application Form

Healthcare Startup Incubator (HSI)Application

at WITS
Healthcare Startup Incubator (HSI)

Whether you're developing a new idea or advancing an existing company, HSI provides the resources, network, and support to accelerate your journey.

In addition to a structured 16-week program, physical work-space and access to industry experts, the program also offers founders a Demo Day at the conclusion of the program. This event is an opportunity to present your business to investors.

Admission to HSI is competitive, with a limited number of applicants selected for each cohort. HSI does not require a program fee. Instead, selected companies participate in the incubator in exchange for an equity stake, aligning the success of HSI with the success of the ventures it supports.

The application deadline is December 1, 2026.

For questions, additional information, or inquiries, please contact jrhollander@wits.edu.
Personal Information:
Full Name

First NameMiddle NameLast Name
List the names of any other members of your start-up team
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Phone Number
Format: (000) 000-0000.
E-mail
example@example.com
Your Business Idea
Describe the business/idea
Have you already started this business? If so, how long has it been operational?
Describe your team's past work history, education or other background that will help you be successful in this venture
Resume (Include a resume for each team member
Resume - Team Member #1

Cancelof
Resume - Team Member #2

Cancelof
Send Application:
Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Should be Empty:

Healthcare Startup Incubator (HSI)Application

Personal Information:

Your Business Idea

Resume (Include a resume for each team member

Send Application: