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Company Name:
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Use the company information submitted for the regional Red Herring 100 Award?
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What regional Red Herring 100 did you compete in?
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What year did you last compete in a regional Red Herring 100?
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Address:
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Address 2:
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City:
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State/Province
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Postal Code
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Country
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Phone Number:
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Fax Number:
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Company Website (URL):
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Industry Sector:
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Month/Year Founded:
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Contact Person's Name:
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Contact Person's Email Address:
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Number of Employees:
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CEO Name:
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CEO Phone Number:
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CEO Email Address:
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Assistant's Name:
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Assistant's Phone Number:
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Assistant's Email:
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Press Relations Contact Name:
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Press Relations Contact Phone Number:
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Name of CFO:
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Press Relations Contact Email:
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Name of Chairman:
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Board of Directors (please list names):
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CEO Profile:
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FINANCIAL INFORMATION: Do you wish to keep this information confidential? It will never be published or disclosed to anyone outside of the judging process.
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Yes
No
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Revenues ($Millions):
2008, 2009, 2010(Est.)
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Net Income ($Millions): 2008, 2009, 2010(Est.)
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Profitable? (If not, please state when expected MM/YY):
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If applicable, what is company's monthly burn rate?:
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What does your company do? (What problem does your product/service solve?):
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What technological advantage does your product/service offer?:
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Competition - name and contrast three competitors:
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Primary advantage over competitors:
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Business model (how do you make money)?:
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Are your company's products protected (patents, licences, etc.)?:
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List your three largest customers:
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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.
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Yes
No
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How was your company founded (event or person that inspired company creation)?:
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Company's biggest achievement during the past year:
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Company's biggest challenge during the next year:
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Is there anything else we should know about your company?:
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Total Number of Rounds:
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Total funding to date ($M):
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Date of latest round (MM/DD/YY):
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Seed/Angel Funding ($M):
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Round 1 Funding ($M):
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Round 1 Investors (please list):
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Round 2 Funding ($M):
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Round 2 Investors (please list):
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Round 3 Funding ($M):
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Round 3 Investors (please list):
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Regional Event Participated in:
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Year of Participation (as Finalist or Winner)
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