Register for VCIR 2009

Submit Your Business Plan

Contact First Name:
Contact Last Name:
Postition:
Phone:
Fax:
Company Name:
Contact Email:
Company Address:
Address Line 2:
City:   State:   Zip:
Company Website:
Presented at VCIR before:   If Yes, when:
Stage of Development:
Years in Business:
Primary Industry:
Est Current Employees:
Invested Capital To Date:
Total Financing Sought:
Total Financing Type:
Primary Use of Funds:   Comment:
Referral Source:   Indiv/Org Name, if any:
Brief Description of the Business:
Primary Competitors: Name:   Location:   Est Revenue:
Name:   Location:   Est Revenue:
Name:   Location:   Est Revenue:

Primary Customers (type):

Management Team: Name:   Postition:
Experience:   Prev Title:

Name:   Postition:
Experience:   Prev Title:

Name:   Postition:
Experience:   Prev Title:



Financial Data:
2007 2008 2009 2010 2011
Revenue
Net Pretax Earnings
EBITDA


Business Plan:
Please fill out the following information about your company. At the bottom of the form you’ll be asked to upload a short (less than 4 page) executive summary of your business to be used by the selection committee in making its determination. If you have any questions about this form, please email submissions@vcirwinter.com