RED HERRING 100 ASIA SUBMISSION FORM - Deadline: July 30, 2010
Enter Email Address to Receive Confirmation of Submission:
Company Name:
Address:
Address 2:
City:
State/Province
Postal Code:
Country:
Phone Number:
Fax Number
Company Website (URL):
Industry Sector:
Month/Year Founded:
Number of Employees:
Name of CEO:
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:
Press Relations Contact Email:
Name of CFO:
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 ($Millions): 2008, 2009, 2010 (Est.)
Net Income ($Millions): 2008, 2009 2010(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):