T1D Moonshot Founder Application

New Application Available!

We have a new and improved application process, please go to www.startuphealth.com/apply-now to submit your founder application.

T1D Moonshot Founder Application

The T1D Moonshot Fellowship is a three-year program at Health Transformer University for entrepreneurs and innovators who are collaborating on the T1D Moonshot. The T1D Moonshot is a unified, global collaboration to accelerate the commercialization and scaling of breakthrough health innovations for the prevention, management, or cure of Type 1 diabetes.
Prior to joining, you will meet with our Admissions team so we can get to know you better. As a first step, please complete this Founder Application - answering a few simple questions about you and your company.

Founder Information
First Name*
Last Name*
Company Name*
Title/Role*
Email*
example@example.com
LinkedIn Profile*
Please include a direct link
Founder Bios (backgrounds, roles and full-time/part-time status)*
Founder Introduction Video*
Please create a video to introduce yourself to the StartUp Health team (tell us about your background and why you are passionate about your company's vision)! Enter the URL of a 60-90 second video (unlisted on YouTube, Vimeo, etc.).
Are you willing to provide peer support to other Health Transformers in the StartUp Health community?*

YesNo
Your Moonshot Vision
Company Website*
Please include a direct link
Tell us about your company's long-term vision and moonshot impact.*
Describe what your company does in 140 characters or less.*

0/140
What are your top three challenges/needs?*
What are your top three strengths/opportunities?*
Company Information
Presentation Link*
Please provide a link (Dropbox, Google Drive, etc.) to your most recent presentation deck.
Company's Primary Location/Headquarters*
City, St and/or Country
Number of Full-Time Team Members*
Working solely, full-time on the company
Team Diversity - please let us know if any of your founders fit in the categories below by checking the applicable boxes*

Female FoundersMD/PhDsBIPOCSerial EntrepreneursLBGTQ+None of abovePrefer not to answerOther
Advisor/Board Member Bios*
Your Product Stage*

ConceptPrototypeBetaMarket
Please provide short overview on your current traction (revenue, user/pilot metrics, product development/validation, etc.)*
Total Capital Raised to Date (type and amount)*
(e.g. $200K F&F or $5M Series A, etc.)
How are you currently funding the business (revenue, grants, founder investment, external investment, etc.) and how many months runway do you have?*
How did you hear about StartUp Health?*

WebsiteNewsletterSocial MediaIndustry EventStartUp Health MagazineMet StartUp Health Team MemberReferralAttended StartUp Health Festival at HLTH/ViVE
StartUp Health Team Member met or referred by:*

Steven KreinUnity StoakesKatya HancockBari KreinLauren SchaferLogan PlasterJennifer HankinRicco MendesPriya ReddyT1D Moonshot Impact Board Member
Referred By:*
Your Phone Number*

Area CodePhone Number
Your Mailing Address
Street Address*
Street Address Line 2
City*
State
(if a U.S. company)
Postal / Zip Code*
Country*
Founder T-Shirt Size*

SmallMediumLargeX-Large
Should be Empty:

New Application Available!

T1D Moonshot Founder Application

Founder Information

Your Moonshot Vision

Company Information

Your Mailing Address