Accelerator Application
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Founder Information
Founder Name
*
First Name
Last Name
Founder Email
*
example@example.com
Founder Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
LinkedIn Profile URL
LinkedIn Profile URL (Clean)
Business Name
*
Business Country
*
Please Select
United States
Afghanistan
Åland Islands
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bonaire, Sint Eustatius and Saba
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cabo Verde
Cambodia
Cameroon
Canada
Cayman Islands
Central African Republic
Chad
Chile
China
Colombia
Comoros
Congo (Democratic Republic)
Congo (Republic)
Cook Islands
Costa Rica
Côte d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czechia
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Eswatini
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Isle of Man
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macao
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
North Korea
North Macedonia
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Poland
Portugal
Puerto Rico
Qatar
Réunion
Romania
Russia
Rwanda
Saint Barthélemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maarten
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Korea
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tonga
Trinidad and Tobago
Tunisia
Türkiye
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
Virgin Islands (British)
Virgin Islands (U.S.)
Wallis and Futuna
Yemen
Zambia
Zimbabwe
Business State
*
Please Select
Tennessee
Alabama
Alaska
American Samoa
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Texas
U.S. Virgin Islands
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Business City
*
Business Website
Business Website (Clean)
Are you a first-time founder?
*
Yes
No
Are you working on this business full-time?
*
Yes
No
About how many hours per week are you actively working on the business?
*
Please Select
Less than 10
10–20
20–30
30+
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About You
This section is optional and used for aggregate reporting purposes only. Your answers have no impact on your application or selection.
Race and ethnicity
Please Select
American Indian or Alaskan Native
Asian
Black or African American
Hispanic or Latino
Middle Eastern or North African
Native Hawaiian or Other Pacific Islander
White
Prefer not to respond
Other
Gender
Please Select
Female
Male
Non-Binary
Prefer not to respond
Other
Do you identify as LGBTQIA+?
Please Select
No
Yes
Prefer not to respond
Have you served in the military?
Please Select
No Military Service
Active Duty
Veteran
Prefer not to respond
Do you have a disability or chronic condition?
Please Select
Yes
No
Prefer not to answer
If yes, are there any access needs the EC should know about?
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Business Information
Tell us about your business.
*
In 2–4 sentences, describe what you're building, who it's for, and the problem it solves.
How long have you been working on this business?
*
Please Select
Not yet started
Less than 6 months
6 to 12 months
1 to 3 years
3+ years
Which industry best fits your business?
*
Please Select
Construction or Built Environment
Consumer Products
Education
Finance or FinTech
Food or Hospitality
Healthcare
HR or Future of Work
Media or Entertainment
Real Estate or PropTech
Retail or E-commerce
Services
Social Enterprise or Nonprofit
Technology or SaaS
Transportation or Logistics
Other
Which best describes your healthcare focus?
*
Please Select
Provider
Payor
Medtech or Device
Consumer Digital Health
Care Delivery / Health Services
Healthcare IT or Workflow
Life Sciences
Behavioral Health
Population Health / Value-Based Care
Other
Which best describes your business model?
*
Please Select
B2B
B2C
B2B2C
Marketplace
Other
What best describes your current product or service readiness?
*
Please Select
Idea only
Concept defined
Prototype
MVP built
Launched product or service
Repeatable offering with active customers
Do you currently have customers or users?
*
Please Select
No
Yes, non-paying users
Yes, pilot customers
Yes, paying customers
Yes, repeat or recurring customers
What is your team size today, including yourself?
*
Do not count advisors, mentors, investors, or board members.
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Where You Are Right Now
How many customer discovery or sales conversations have you completed?
*
Please Select
0
1 to 10
11 to 25
26 to 50
50+
What areas of your business do you need the most support with right now?
*
Clarifying Vision, Strategy, and Priorities
Leadership Development and Decision-Making
Branding and Positioning
Marketing and Customer Acquisition
Sales Process and Revenue Growth
Product Development and Product-Market Fit
Business Model and Financial Modeling
Profitability and Cash Flow Management
Raising Capital
Team Building and Culture
Operations and Systems
Technology and Automation
Healthcare Market Navigation, Regulation, and Reimbursement
Other
What is the clearest evidence that this business solves a real problem?
*
Why is now the right time for you to participate in a program?
*
What would success look like for you over the next 6 to 12 months?
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Total revenue for previous year
*
What is your current annualized revenue or most recent 12-month revenue?
*
Total founder cash invested to date
*
Total personal cash you've put into the business
Total grant funding received
*
Total investor capital raised
*
Total debt leveraged to date
*
Program Investment
Our programs range in cost based on stage, intensity, and duration. After reviewing your application, we'll recommend the program that best fits where your business is today. - TakeOff $500 - InFlight $1,000 - Project Healthcare $6,000 Financial aid and payment plans are available for every program and do not affect admissions decisions.
What level of program investment could you make in the next 6 months?
*
Up to $49
Up to $149
Up to $500
Up to $1,000
Up to $6,000
Any of the above with a payment plan
I would need financial aid at any level
Financial Aid Request
The EC is a nonprofit, and our financial aid budget is limited. We're able to award aid to a small number of founders each cohort, and we prioritize founders for whom the program fee is a genuine barrier to participating. Requesting aid has no impact on your admissions decision. Aid is based on need, not merit, and your answers here are reviewed separately, after program decisions are made. If you're able to cover the fee, or if a payment plan would make it work, please select that option so we can direct aid to founders who have no other way in.
Would you like to be considered for financial aid?
*
Please Select
No, I can cover the fee
Yes, I would like to be considered
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Financial Aid Request
What is your approximate annual household income?
*
Please Select
Under $50,000
$50,000 to $100,000
$100,000 to $150,000
$150,000 to $250,000
Over $250,000
Prefer not to say
How many people depend on this income, including yourself?
*
Please Select
1
2
3
4
5 or more
What amount could you or your business contribute toward the program fee?
*
Enter a dollar amount. Enter 0 if you are unable to contribute anything at this time.
Would a payment plan alone make the program affordable, without financial aid?
*
Please Select
Yes
No
Not sure
Is there anything else you would like us to know about your situation?
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How did you hear about the EC accelerator?
*
Please Select
Search Engine
Friend or Colleague
Conference or Event
Partner Organization
EC Employee
EC Advisor
EC Program Alumni
EC Email Newsletter
Instagram
LinkedIn
Facebook
TikTok
Other
If other, how did you hear about the EC accelerator?
*
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