APPLICATION FORM

Center for Entrepreneurial Leadership| BITS -

Pilani
 INSTRUCTIONS

1) Be precise and concise while answering the

questions.
2) Please don’t give false information.
3) Make sure you answer is in Arial, 14 Bold.
4) When done filling the form name it as <Start-up
Name>.doc
5) Send the filled up form to conquest@celbits.orgwith
SUBJECT : Application Form – Conquest 2011
6) Partially filled forms will not be accepted.
7) Results will be announced on www.celbits.org/conquest
and via e-mail.
8) By submitting this application, you accept the Terms
and Conditions for Conquest 2011.

©Center for Entrepreneurial Leadership | BITS-Pilani

 START

1 Start-up Information
a. Start-up Name:
b. Website (if any):
c. Phone number(s):
2 About Founders:
No. of founders:
2.1 Founder 1(Repeat if more than one founder)
a. Name:
b. Phone:
c. E-mail:
d. Why do you want to be an entrepreneur?
Work Experience (Repeat if more than one
e.
company)
Company Name:
Year / Month of Joining:
Year / Month of Leaving:
Title:
Brief about the work you did there:

Why did you quit?

©Center for Entrepreneurial Leadership | BITS-Pilani

 College Education (Repeat if more than one
f.
college)
College Name:
Course:
Year / Month of Joining:
Year / Month of Leaving or Graduation:
Other activities or achievements while at college:

3. About Venture

3a.What is the problem your venture is solving or trying

to solve?

3b. Market: Provide a brief description of your product /

service and your market / end-users?Why are you
convinced that there is / will be a market for your
product / service?

©Center for Entrepreneurial Leadership | BITS-Pilani

3c. Your proposition: Why do you believe your product /
solution is the best in class or unique, i.e. what are
your USPs?

3d. Explain what domain expertise each of the founders

brings to the venture to make it “stand out”.

3e. Competition: Who are your competitors? Are there

alternate solutions possible for the problem you are
trying to solve? (i.e, is it possible that the market
opportunity you see can completely disappear because
of a disruptive technology or development?)

©Center for Entrepreneurial Leadership | BITS-Pilani

3e. Resources: What do you need to get to a stage of
launching your product / service: people, capital
investments, technology, market linkages, etc.? What
do you need to get to a stage of steady-state revenues
and profits? How long do you reckon it will take to get
to these milestones? What are you doing to get these
resources lined up?

©Center for Entrepreneurial Leadership | BITS-Pilani

4. Current Status of Venture
a. Stage:
(Product: idea stage / alpha / beta
Service: idea stage / pilot completed /
operational)

b. Monthly expenditure:

c. Revenues:

d. Current Investments:

e. Incorporated as :

f. How long will it take before you can start

sales/operations?

(Enter fields relevant to the stage of the start-up)

©Center for Entrepreneurial Leadership | BITS-Pilani