Axioventures Pilot Program Application

Important Information:

The information you provide here and at any point in the future will be kept strictly confidentially within our research team.

That said, we understand the sensitivity of disclosing certain information. If an NDA is needed to answer any of the following questions, please ONLY provide information that does not require such an NDA. If we decide to engage your company in the program, we will address an NDA at that point.

We are accepting applications for this pilot program until May 30th. After reviewing the submitted applications, we will identify those that we feel could be a good fit and conduct an initial interview with the contact person given. From these interviews, we will narrow the candidate companies down to three or less with who to engage in Phase One as described in the proposal materials.

Our target company profile is:

An under-performing, early-stage Angel or VC Portfolio Company
6-15 team members
A strong need, desire, and commitment to becoming a more effective and successful team
A leader who is committed to “doing the work” of becoming a better thinker-leader

We will be delivering $25K – $50K worth of world-class services PRO BONO* to the selected company(s) and its team. If your company is selected, all team members will be expected to fully and earnestly participate in the program (and it is in the interest of your company’s success that they do so).

* Most of the services, other than the workshops, will be conducted via telephone and videoconference. Depending on the client company’s location, we may need to request travel expense reimbursement .

Primary Name Contact Name (Owner / CEO)(Required)

First Last

Company Name(Required)

Location(Required)

City State

Best Phone Number(Required)

Email Address(Required)

You will NOT be placed on any mailing or marketing list outside this project.

Enter Email Confirm Email

If applicable, who referred you to this opportunity (name)?

Without violating any NDA-worthy information, briefly describe the nature of the company's product(s) or service(s).

Including yourself, how many full-time or otherwise key people are on the team (even if not on a payroll)(Required)

Company History

How would you describe your most pressing "people problems" (including your own "issues") that you feel are undermining or limiting your company's success?(Required)

Which of the follow best describes where you are?(Required)

How critical and urgent is it that you get these “people problems” solved?

Yesterday! – Seriously, it’s critical.	We’re nearly at the end of our rope.	It’s a big issue, but we’re not on the verge of failure.	We heading in the right direction, but need help.	It would just be nice.