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Name
First Last
Address
Street Address Address Line 2 City Province Postal Code
Email
Phone
Year of Birth
Name of your company
What will you sell?
Who will buy it?
How will your business idea help people?
KA-CHING
What will you charge?
How will you get paid?
How else will you make money?
HUSTLING
How will customers learn about your business?
How can you encourage referrals?
SUCCESS
The project will be successful when it achieves these metrics:
Number of Customers or...
Annual net income...
Or other metric
OBSTACLES / CHALLENGES / OPEN QUESTIONS
Specific concern or question #1
Proposed solution to concern #1
Opportunities
Are you or do you plan on going global with your startup? What does your startup need to get to the next level?
More
Keep it brief, but share anything else here...
Last words...
1 minute video
Upload 1 minute video if you can - not required
Would you be willing to make yourself available for online, print and broadcast media interviews related to Startup Pitch Nights, Startup Canada or TruShield Insurance?*
- YES
- NO
If selected, do you agree to pitch at Startup Pitch Nights in the region you've signed up in?*
- YES
- NO

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