Cann10 Accelerator Application Form Please fill-in the following form in English and send to [email protected] Application Date Organization Background Company Name Year Established Full Address Website No. of Employees No. of R&D Personnel Project Title The Problem The Solution Innovation & Advantages IP Status Page 1/3 Market Potential Company Current Status Do you have an initial regulatory plan? Yes No If yes, please describe your Planned Regulatory Strategy Team Members Roadmap - Milestones to Commercialization The Resources Needed Investment required for next round: Additional investments in future rounds until product commercialization: Amount invested in the company to-date: Company valuation for next round Page 2/3 Company's Shareholders Shareholder Name % Shareholder Name % Contact Person Data Last Name First Name Function Title E-mail Mobile Direct Telephone Fax Page 3/3
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