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The Changemakers Collective
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Silverback Ventures Impact Hub Services Request Form
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Changemakers Collective Application
Our goal is to amplify the voice and multiply the efforts through curated partnerships with like-minded service partners.
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First Name
*
Last Name
*
Company Name
*
Website / URL
*
Email
*
What is the nature of your business?
*
For profit
Non-profit
Undecided
No idea – I’m new to entrepreneurship
Describe your business or idea:
*
How many people work at your business?
*
Just me
2-5
6-10
11+
Nobody yet – that’s why I’m here
Where are you in your entrepreneurial journey?
*
I have a passion I want to turn into a business but haven’t jumped into the deep end yet.
I have a side hustle that I want to turn into a full-time business.
I have an established business, but I’m stuck and cannot grow.
I’m applying for a friend I think would benefit.
How long have you been in business?
*
Not started yet
Startup to 2 years
3-5 years
5+ years
Silverback Ventures is on mission to create multiplication of impact that will change the world. How will your business create a positive impact in the community and beyond?
*
What is the primary reason for applying to the cohort?
*
Potential funding partner
Learning how to turn my passion into a business.
Understanding how to scale my business.
Gaining clarity around our vision, mission and values to create a plan for growth.
I’m new to entrepreneurship and want to learn how to move forward.
My business is stuck and needs a new perspective to help jump start new growth.
I’m drowning and need help with process, systems and prioritization.
Meeting other entrepreneurs to share ideas and gain insights.
The cohort will run for 6 weeks (3 weeks for future entrepreneurs) and meet weekly. Can you commit to meeting weekly?
*
Yes
No
What is your preferred day and time for meetings?
*
Weekday mornings (before 10AM)
Weekday lunch and learns
Weekday evenings (after 6PM)
Would you be interested in sponsoring a friend or colleague for this cohort?
*
Yes
No
If "Yes", please contact us.
If you are selected for further investment by Silverback Ventures, which would you value more?
*
Monetary investment without ongoing advisory services.
Monetary investment with ongoing advisory services.
Ongoing advisory services for equity ownership.
Why should you be selected for this program? What is your compelling “Why”?
*
If selected, how many from your company will be in attendance (max 2)?
*
1
2
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