Your name: *

Your website: *

Your email: *

Your company name: *

Your city, state: *

Will you need a housing stipend as part of your participation in this program? (For teams not based in the Triangle) *

Please link to your successful crowdfunding page (type NA if you have not completed a campaign--and proceed to next question): *

If you have not completed a successful crowdfunding campaign, how many units did you sell in 2016? (Note: requirement of 1,000+ units annually to be considered or $20,000 in revenue):

Participating full-time (min 30 hrs per week in Durham) is a requirement of the program. Are you able to commit to this from March 1-April 30, 2017? *

What is your company's value proposition? *

250 characters max, be concise.
Who is your customer? *

150 characters max, be concise.
What is your current revenue? *

What are your plans and goals for 2017? *

250 characters max, be concise
Are you currently selling direct to consumer via web? What would you like to get out of participation in the Startup Stampede? *

250 characters max