GENIUS NY 4 Business Competition

GENIUS NY 4 Registration Form

After completing this form, you will receive an email within a few minutes with a link. Please click the link to verify your email address and activate your account. To ensure you receive this email, please add geniusny@thetechgarden.com to your address book.

1. First Name

2. Last Name

3. Company Name

4. Phone Number

5. Street Address

6. Town

7. State or Province

8. Zip or Post Code

9. Country

10. Email

11. Create a password

(minimum of 6 characters)

12. Confirm your password

13. What category best fits your concept/product?

14. Are you a US citizen, or if not, are you able to obtain appropriate US work/travel visas?

Yes

No

15. Do you speak and write English?

Yes

No

16. Are you willing and able to relocate to Central New York area for the full accelerator period of 12 months?

Yes

No

17. Will you be able to provide supporting documents, photos, and/or videos associated with you and your project?

Yes

No

18. Are you willing to have an independent third party examine your project application?

Yes

No

19. Will you be able to provide references and/or letters of support from people who know you and your work?

Yes

No

20. Are you willing to seek outside equity capital for the company from other investors?

Yes

No