CIP Application Form

Basic Information
Name *
National ID *
Education *	Student Graduate
Age *	Other 18 - 21 22 - 25 26 - 30 31 - 35 35 - 40 +40
Other *
Email *
Mobile Number *
LinkedIn *
Role *	Other Founder Co-Founder
Other *
Gender *	Male Female
Startup Information
Startup Name *
Governorate *	Other Aswan Qena New Valley Suhag Minya Banisuef Fayoum Alexandria Ismailia Portsaid Menoa Mansoura Benha
Other *
Website
Facebook Page
When did you start working on the startup? *	0 - 6 Months 6- 12 Months 1 - 3 years 3 - 5 years +5 years
Are you working full time on the startup? *	Full Time Part-time No
Has your startup been part in any incubation, acceleration, or venture building program? *	Yes No
Please state name of program and duration *
Startup Overview *	Rich text editor StartupOverview Required Field
Is your startup legally registered?	Yes No
Please state year of registration *
Sector *	Other Agri-food Textile & Ready made garments Energy Engineering Recycling Healthcare Education Manufacturing E-commerce Smart Cities Transport and logistics Tourism
Other *
What is the problem you are trying to solve, and how your startup is solving this problem?	Rich text editor Problem
Describe  your Business model briefly? Value proposition,  market segments and revenue model	Rich text editor BusinessModel
Stage *	Other Ideation prototype MVP incubated startup growth or scaleup startup
Other *
What are the key milestones you have achieved so far? *
What are the next milestones you are planning to achieve? *
How many employees are in the start-up including the founding team members? *Please specify how many female employees vs male employees (ex: Total 8 including 4 female employees)
Does your business generate revenue? *	Yes No
What is the average annual Revenues *
Do you have investors?	Yes No
Please specify stage and type of investment
Please upload your business plan	An error has occured while uploading the selected filePlease make sure that the file within allowed size 15M.Not allowed extension
Incubation Needs
What are the current challenges/ pain points affecting your start up? *
What motivates you to join CREATIVA incubation program? *	Rich text editor WhyJoinCIP Required Field
What are the key areas you need a mentor to help you navigate? *	Other Marketing Technology and manufacturing Regulatory Business development and growth Operations Financial Investment
Other *
How did you hear about the program? *	Other Facebook Incubator/ Accelerator Recommended by a friend
Other *
I understand that if I am selected to the program, I will be committed to attending the incubation trainings for 9 months in my governorate and the speed mentoring events *	Agree