Please fill out this questionnaire to serve as an Executive Summary to guide your 7 min pitch presentation deck. Selections and notifications of finalists will be made by SEPTEMBER 6th, 2019.
Email*
Valid email
This form is collecting emails.Change settings
Image title
*
Image title
*
Hover text
Loading image…
Loading...
Loading…
First Name Last Name
*
Question
First Name Last Name
*
Question Type
Short answer
Paragraph
Multiple choice
Checkboxes
Dropdown
File upload
Linear scale
Multiple choice grid
Checkbox grid
Date
Time
Description
Loading image…
Caption
Option 1
Other…
Add option
or
add "Other"
…
Select at least
Select at most
Select exactly
Number
Custom error text
Answer key
(0 points)
Loading...
Loading…
One-Line Pitch (needed for marketing materials, if accepted)
*
Question
One-Line Pitch (needed for marketing materials, if accepted)
*
Question Type
Short answer
Paragraph
Multiple choice
Checkboxes
Dropdown
File upload
Linear scale
Multiple choice grid
Checkbox grid
Date
Time
Description
Loading image…
Caption
Long answer text
Length
Regular expression
Maximum character count
Minimum character count
Number
Custom error text
Answer key
(0 points)
Loading...
Loading…
Company Description (Limit to 1 paragraph; needed for materials)
*
Question
Company Description (Limit to 1 paragraph; needed for materials)
*
Question Type
Short answer
Paragraph
Multiple choice
Checkboxes
Dropdown
File upload
Linear scale
Multiple choice grid
Checkbox grid
Date
Time
Description
Loading image…
Caption
Long answer text
Length
Regular expression
Maximum character count
Minimum character count
Number
Custom error text
Answer key
(0 points)
Loading...
Loading…
What is your product or service? (Limit 1 paragraph)
*
Question
What is your product or service? (Limit 1 paragraph)
*
Question Type
Short answer
Paragraph
Multiple choice
Checkboxes
Dropdown
File upload
Linear scale
Multiple choice grid
Checkbox grid
Date
Time
Description
Loading image…
Caption
Long answer text
Length
Regular expression
Maximum character count
Minimum character count
Number
Custom error text
Answer key
(0 points)
Loading...
Loading…
Define your target market - who will buy it and why - customer need that your company is addressing. (Limit 1 paragraph):
*
Question
Define your target market - who will buy it and why - customer need that your company is addressing. (Limit 1 paragraph):
*
Question Type
Short answer
Paragraph
Multiple choice
Checkboxes
Dropdown
File upload
Linear scale
Multiple choice grid
Checkbox grid
Date
Time
Description
Loading image…
Caption
Long answer text
Length
Regular expression
Maximum character count
Minimum character count
Number
Custom error text
Answer key
(0 points)
Loading...
Loading…
Competition? How are you differentiated? What is the current standard of care? (Limit 1 paragraph)
*
Question
Competition? How are you differentiated? What is the current standard of care? (Limit 1 paragraph)
*
Question Type
Short answer
Paragraph
Multiple choice
Checkboxes
Dropdown
File upload
Linear scale
Multiple choice grid
Checkbox grid
Date
Time
Description
Loading image…
Caption
Long answer text
Length
Regular expression
Maximum character count
Minimum character count
Number
Custom error text
Answer key
(0 points)
Loading...
Loading…
Revenue or Business Model (Clear Revenue model? Sales Cycle? Life-time value? Recurring or one-time? (Limit 1 paragraph)
*
Question
Revenue or Business Model (Clear Revenue model? Sales Cycle? Life-time value? Recurring or one-time? (Limit 1 paragraph)
*
Question Type
Short answer
Paragraph
Multiple choice
Checkboxes
Dropdown
File upload
Linear scale
Multiple choice grid
Checkbox grid
Date
Time
Description
Loading image…
Caption
Long answer text
Length
Regular expression
Maximum character count
Minimum character count
Number
Custom error text
Answer key
(0 points)
Loading...
Loading…
Please outline your current intellectual property strategy, or other barriers of entry if applicable. (Limit to 1 paragraph)
*
Question
Please outline your current intellectual property strategy, or other barriers of entry if applicable. (Limit to 1 paragraph)
*
Question Type
Short answer
Paragraph
Multiple choice
Checkboxes
Dropdown
File upload
Linear scale
Multiple choice grid
Checkbox grid
Date
Time
Description
Loading image…
Caption
Long answer text
Length
Regular expression
Maximum character count
Minimum character count
Number
Custom error text
Answer key
(0 points)
Loading...
Loading…
Describe your regulatory plan, if applicable, and where you are now in that process (Limit to 1 paragraph)
*
Question
Describe your regulatory plan, if applicable, and where you are now in that process (Limit to 1 paragraph)
*
Question Type
Short answer
Paragraph
Multiple choice
Checkboxes
Dropdown
File upload
Linear scale
Multiple choice grid
Checkbox grid
Date
Time
Description
Loading image…
Caption
Long answer text
Length
Regular expression
Maximum character count
Minimum character count
Number
Custom error text
Answer key
(0 points)
Loading...
Loading…
Identify your key team members, advisers and their affiliations (Limit to 1 paragraph)
*
Question
Identify your key team members, advisers and their affiliations (Limit to 1 paragraph)
*
Question Type
Short answer
Paragraph
Multiple choice
Checkboxes
Dropdown
File upload
Linear scale
Multiple choice grid
Checkbox grid
Date
Time
Description
Loading image…
Caption
Long answer text
Length
Regular expression
Maximum character count
Minimum character count
Number
Custom error text
Answer key
(0 points)
Loading...
Loading…
What preliminary data / Proof of Concept Data do you have?
*
Question
What preliminary data / Proof of Concept Data do you have?
*
Question Type
Short answer
Paragraph
Multiple choice
Checkboxes
Dropdown
File upload
Linear scale
Multiple choice grid
Checkbox grid
Date
Time
Description
Loading image…
Caption
Long answer text
Length
Regular expression
Maximum character count
Minimum character count
Number
Custom error text
Answer key
(0 points)
Loading...
Loading…
Please upload an informative Figure / Graph /Data
*
Question
Please upload an informative Figure / Graph /Data
*
Question Type
Short answer
Paragraph
Multiple choice
Checkboxes
Dropdown
File upload
Linear scale
Multiple choice grid
Checkbox grid
Date
Time
Description
Loading image…
Caption
Add file
View folder
Allow only specific file types
Maximum number of files
1
5
10
Maximum file size
1 MB
10 MB
100 MB
1 GB
10 GB
View folder
Answer key
(0 points)
Loading...
Loading…
Link to Sheets
The number of responses collected by this form may exceed the limit supported by Sheets. If you're having trouble viewing your responses in Sheets, try downloading a .CSV instead.
Message for respondents
This form is no longer accepting responses
Summary
Question
Individual
Insights
Total points distribution
Loading...
Loading responses…
First Name Last Name
Copy
No responses yet for this question.
One-Line Pitch (needed for marketing materials, if accepted)
No responses yet for this question.
Company Description (Limit to 1 paragraph; needed for materials)
No responses yet for this question.
What is your product or service? (Limit 1 paragraph)
No responses yet for this question.
Define your target market - who will buy it and why - customer need that your company is addressing. (Limit 1 paragraph):
No responses yet for this question.
Competition? How are you differentiated? What is the current standard of care? (Limit 1 paragraph)
No responses yet for this question.
Revenue or Business Model (Clear Revenue model? Sales Cycle? Life-time value? Recurring or one-time? (Limit 1 paragraph)
No responses yet for this question.
Please outline your current intellectual property strategy, or other barriers of entry if applicable. (Limit to 1 paragraph)
No responses yet for this question.
Describe your regulatory plan, if applicable, and where you are now in that process (Limit to 1 paragraph)
No responses yet for this question.
Identify your key team members, advisers and their affiliations (Limit to 1 paragraph)
No responses yet for this question.
What preliminary data / Proof of Concept Data do you have?
No responses yet for this question.
Please upload an informative Figure / Graph /Data
No responses yet for this question.
Waiting for responses
of
13
of
1
Loading...
Loading response…
Grades from previous versions of this form are hidden. Learn more
Settings
Release grades
Respondent settings
Global quiz defaults
Default question point value
Point values for every new question
points
Responses
Manage how responses are collected and protected
Collect email addresses
Required by Locked mode
Required to send response copies
Respondents will manually enter their email response
Do not collect
Verified
Responder input
Send responders a copy of their response
Disabled by Locked mode
Requires Collect email addresses
Off
When requested
Always
Requires sign in
File upload
Total size limit for all uploaded files
This limit is smaller than the max size of a single response.
Responses will not be accepted after the limit is reached. Learn more
1 GB
10 GB
100 GB
1 TB
Presentation
Manage how the form and responses are presented
Form presentation
After submission
Confirmation message
On behalf of Women in Bio Chicago, we thank you for your submission.
Chi-WIB team