Membership Application Form

We are a community of passionate entrepreneurs developing solutions to solve the biggest climate and environmental challenges – solutions that will not only transform our daily lives but revolutionize the way society thinks about, consumes, and engages with key global resources. This application is for startup incubation at Greentown Labs.

Questions/Contact: Sam Crum, scrum@greentownlabs.com.

Please note that the contents of your application will be shared with the Greentown Team, Board of Directors, and Advisory Board

General Company Information

Company Name

Company Website

Company Street Address

Country

City

State/Province

Zip Code

Description of Company

Brief Marketing Description:

Please keep this to one sentence. This description will be added to our website if accepted for membership.

Cleantech Sector:

What sector are you in?

How does your company positively impact the climate or environment?

The strongest applications estimate GHG emissions that could realistically be offset if the solution is adopted at scale.

Founders and Funds

Number of Full-Time Employees:

Number of Part-Time Employees:

Of the total number of employees, how many are founders?

Are any employees serial entrepreneurs?

YesNo

Founder 1 Contact Information:

First Name

Last Name

Title

Phone

Founder 2 Contact Information:

First Name

Last Name

Title

Phone

Founder 3 Contact Information:

First Name

Last Name

Title

Phone

Current funding to date? (including non-dilutive and grant funding)

Please answer this as accurately as possible in the format of X,XXX,XXX

Is your company generating revenue?

How much revenue have you roughly generated in the past 12 months?

Please answer this as accurately as possible in the format of X,XXX,XXX

How much revenue have you roughly generated in total?

Please answer this as accurately as possible in the format of X,XXX,XXX

Stage

List any Competitions / Awards / Accelerator Programs / Incubators your company has participated in:

	Program	Award Won?	Award Amount ($)	Year
1
2
3
4
5

Please briefly describe your business model.

Please keep this to 200 words or less.

Please briefly outline your potential markets and which will be your beachhead markets.

Please keep this to 200 words or less.

What is your total addressable market and how much can you realistically capture?

Please keep this to 200 words or less.

What is your company’s competitive advantage?

Please keep this to 200 words or less.

Technology Readiness Level:

Has your company been awarded any patents?

YesNoNo – we have filed one or more patents but have not been awarded

Number of Patents Pending:

Number of Patents Approved:

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Space Needs and Move In

Do you plan to prototype within the first six months at Greentown Labs?

YesNo

How much space at Greentown Labs will your company need?
As you estimate your space needs, please keep in mind our monthly membership rates.

Desks ($580/desk /month)

Extra Keys ($355/extra person/month)

Prototyping Lab SF ($4.80/square foot/month)

Wet Lab Benches ($3,835/5ft bench/month)

Comments

How much do you expect to grow during your first 12 months at Greentown Labs?

If possible, project the size and timeline of growth so we can do our best to locate your team in a space well suited to expansion

Interested move-in date:

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Additional Information and Submission

Please upload your overview presentation for the recruitment team to review during the application process.

If there is anything confidential within this deck, please keep in mind this is shared with the Boards of Greentown Labs.

Please upload your logo for the marketing team to have on file if accepted for membership.

Upload any supplemental information you think we should review in consideration of your application.

Bill Payer’s Email: Please enter the email of the person that would be receiving contracts and invoices from Greentown Labs. If accepted, this person will receive and sign initial member paperwork (can be changed later)

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