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2011 Red Herring Europe Submission Form: Deadline - December 31, 2010
Company Name:
Address:
Address 2:
City:
State/Province:
Postal Code:
Country:
Phone Number:
Fax Number:
Company Website (URL):
Industry Sector:
Biosciences/Biomedical/Nanotechnology
CleanTech
Communications
Computers/Software/Technology
Computing
Energy
Engineering
Entertainment & Media
Finance/Banking/Brokerage
HealthCare/Pharmaceuticals
Internet & Services
IT Consulting & Services
Life Sciences
Marketing/Advertising/PR
Mobile
SaaS
Social Network/Media
Security & Defense
Semiconductor
Software
Telecommunications
Other
Month/Year Founded:
Contact Person's Name:
Contact Person's Email Address:
Number of Employees:
CEO Name:
CEO Phone Number:
CEO Email Address:
Assistant's Name:
Assistant's Phone Number:
Assistant's Email:
Press Relations Contact Name:
Press Relations Contact Phone Number:
Name of CFO:
Press Relations Contact Email:
Name of Chairman:
Board of Directors (please list names):
CEO Profile:
FINANCIAL INFORMATION: Do you wish to keep this information confidential? It will never be published or disclosed to anyone outside of the judging process.
Yes
No
Revenues ($Millions): 2009, 2010, 2011(Est.)
Net Income ($Millions): 2009, 2010, 2011(Est.)
Profitable? (If not, please state when expected MM/YY):
If applicable, what is company's monthly burn rate?:
What does your company do? (What problem does your product/service solve?):
What technological advantage does your product/service offer?:
Competition - name and contrast three competitors:
Primary advantage over competitors:
Business model (how do you make money)?:
Are your company's products protected (patents, licences, etc.)?:
List your three largest customers:
FUNDING DATA CONFIDENTIALITY: Do you wish to keep this information confidential? It will never be published or disclosed to anyone outside of the judging process.
Yes
No
How was your company founded (event or person that inspired company creation)?:
Company's biggest achievement during the past year:
Company's biggest challenge during the next year:
Is there anything else we should know about your company?:
Total Number of Rounds:
Total funding to date ($M):
Date of latest round (MM/DD/YY):
Seed/Angel Funding ($M):
Round 1 Funding ($M):
Round 1 Investors (please list):
Round 2 Funding ($M):
Round 2 Investors (please list):
Round 3 Funding ($M):
Round 3 Investors (please list):