ENTREPRENEUR REGISTRATION

When you register with MedTech IGNITE as an entrepreneur, a world of wisdom and experience will become available to you as part of our mentor matching program. Mentors have a proven track record in the medical device field and have graciously offered their time to help ensure the continued strength of our industry.

Please note that we will keep your information confidential - however, we will not provide a non-disclosure agreement to applicants. Disclosure of proprietary business or technology information is at your discretion.

Please note that we are launching the IGNITE program with a small group of companies and as such, we may not be able to connect you with a coach immediately. However, every effort will be made to match you with an appropriate coach as soon as possible.

How Will My Application Be Evaluated? (click to read)

What Happens Next? (click to read)

Company Information (fields in bold are required)
Company / Organization Name
First Name
Last Name
Email
Business Phone
Cell Phone
Job Title
Address Line 1
Address Line 2
City
State	-- please make a selection -- Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Palau Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Not in USA
ZIP/Postal Code
Have you formed a company?	Yes Is in the process of being formed now No (please only answer relevant questions below)
When was it founded, and where is it located?
How many employees do you have?
Briefly describe the background and current affiliations of the company founders
Please describe your technology: How does it work? How is it better than what is currently available? (350 words or fewer)
What is your product's status - Alpha? Beta? Has the technology undergone bench testing, experimental modeling, usage? (350 words or fewer)
Please list the sources and amount of funding received to date (i.e. personal, private, or venture capital)
Please describe the target market for your product and your desired customer.
What is the compelling reason for your customer to purchase your product?
What research, if any, have you done on the regulatory pathway for approval of your idea?
What are the three critical hurdles facing you over the the next six months?
What do you hope to accomplish by participating in MedTech IGNITE?
How did you find out about us?

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