Elevate Ventures - Application

Please use the form below to apply for assistance or request funding.

First Name

Last Name

Job Title

Legal Company Name

As filed or planned to be filed with the Indiana Secretary of State’s Office. If your company does not currently have a name, please enter your first and last name

Office Phone

Mobile Phone

Your Entrepreneur-in-Residence (EIR), if you already have one assigned to you:

Application Type

What type of SBIR/STTR support would you like?

SBIR/STTR Grant Type

For additional information about this program, see here.

Qualifying Question

Elevate Ventures invests in qualified Indiana businesses. Do you currently meet or are you willing to meet these requirements?

General eligibility requirements:

Has 500 or fewer employees
Has its headquarters in the State of Indiana or has committed to, or is in the process of, initiating, expanding and/or consolidating operations in the State of Indiana
Is primarily focused on the commercialization of research and development, technology transfer, the application of new technology, or is determined by Elevate Advisors to have significant potential to:

Bring substantial capital into Indiana
Create jobs or
Diversify the business base of Indiana
Generate eventual financial returns

Has, or will have at least fifty percent (50%) of its employees residing in Indiana, or seventy-five percent (75%) of its assets located in Indiana
Has had average annual revenues less than fifty million dollars ($50,000,000) in its two (2) most recent fiscal years and
Is not engaged in a business involving real estate, real estate development, insurance, professional services provided by an accountant or a lawyer or a physician, retail sales (except when the primary purpose of the business is the development or support of electronic commerce using the internet), or oil and gas exploration

Company Information

Street Address

City

State

Zip Code

Please provide a brief summary of your company, product, or idea (limit 255 characters)

Company Website

Company Structure

Industry

Date of Incorporation (mm/dd/yyyy)

Number of current employees

Is a principal of the company a U.S. military veteran, woman or minority (defined below)? “Principal” is defined as founder or c-suite member with at least a 5% equity interest in the company

Is the company veteran owned, controlled or led? The company has at least 51% veteran in its founding/management team or its current governance board or shareholder base, or the company is led by a veteran CEO. Veteran is a person who served on active duty with the U.S. Army, Air Force, Navy, Marine Corps or Coast Guard, for any length of time and at any place and who was discharged or released under conditions other than dishonorable. Reservists or members of the National Guard called to Federal active duty or disabled from a disease or injury incurred or aggravated in line of duty while in training status also qualify as a veteran.

Is the company women owned, controlled, or led? The company has at least 51% women in its founding/management team or its current governance board or shareholder base, or the company is led by a woman CEO.

Is the company minority owned, controlled, or led? The company has at least 51% minority in its founding/management team or its current governance board or shareholder base, or the company is led by a minority group member CEO. “Minority” is defined based on race, ethnicity, and sexual orientation, including African Americans, American Indians and Alaska Natives, Asians and Pacific Islanders, Hispanics, and LGBTQ individuals.

How did you hear about us?

Please specify the referring organization and/or person

List any Indiana higher-education institutions or other organizations assisting your business.

What is the total round (in $) you are raising?

How much private capital have you raised? (just the $ amount, no text please.)

Please list other Investment groups you are working with

SBIR/STTR Information

*SBIR/STTR applicants must apply for matching funds within 90 days of your federal SBIR/STRR award start date.

Do you have any prior knowledge of federal SBIR/STTR programs?

YesNo

Describe new technologies and/or potential technology applications that you are working on. (max 1000 characters)

SBIR/STTR Agency

SBIR/STTR Award Number

Federal Award Amount

SBIR/STTR Proposal Title

SBIR/STTR Solicitation Number

SBIR/STTR Award Start Date

SBIR/STTR Award End Date

Federal Award Principal Investigator Full Name

Principal Investigator Email

SBIR/STTR Phase I Award Number

Attachments

If you have documents such as investor presentations, financial models, or collateral materials you think would be helpful to us in reviewing your application, please upload them here.

For each document, click the Choose File button and click the Upload button.

Attachment - *file size <25MB*

Attachments

Please upload the following documents.
1. SBIR/STTR proposal
2. Federal Award Contract
3. Any other documents such as investor presentations, financial models, or collateral materials you think would be helpful to us in reviewing your application
For each document, click the Choose File button and click the Upload button.

SBIR/STTR proposal - *file size <25MB*

Federal Award letter - *file size <25MB*

Other Attachment - *file size <25MB*

Attachments

Please upload the following documents.

Draft Proposal - *file size <25MB*

Other Attachment - *file size <25MB*

Would you like to receive Elevate's communications to receive notifications on programs, initiatives and events that could help you grow your business?

Yes, count me in. No, I'm not interested.

Contact Information