Elevate Me Entrepreneur Form - Elevate Ventures

First Name *

Last Name *

Email *

Gender

Cell Phone

City

State

What best describes you (select one): *

Name of Company (put N/A if not applicable) *

Minority is defined based on race/ethnicity (African Americans, American Indians & Alaska Natives, Asians & Pacific Islanders, Hispanics) *

Woman Owned/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.) *

Industry/Sector (select one) *

Other (Please specify) *

I have an idea.
I have a business.