QPI Scale-Up Program Application

Scale-Up Program Application

Thank you for your interest in the Scale-Up Program which is led by Queen’s University and supported by the Government of Canada through FedDev Ontario and Invest Ottawa.

The mission of Scale-Up Program is to provide the Eastern Ontario Entrepreneurship Community with resources and tools to scale-up your venture.

We are looking for ventures that are science, tech-based, software, or health innovation, and have developed a minimally-viable-product (MVP). We will provide you with mentorship, programming and tools to take your venture to the next level.

Please answer the following questions which will help us to determine your company's eligibility for our various programs and services.

Upon submission, we will review your application and if we have any questions we will contact you within 7-10 days of receiving your submission. Please allow 2 weeks for a formal response.

If you have any questions about this application please do not hesitate to contact:

Rick Boswell

boswellr@queensu.ca

FormAssembly Code

About You

Contact Info

What is your first name?

What is your last name?

What is your phone number?

What is your email address?

What is your LinkedIn Profile address?

Address

Please provide the address that your venture is working from:

Street Number

Unit Number

Street Name

City

Province

Postal Code

About Your Venture

Description of Your Venture

What description would best describe what stage your venture is currently at?

My venture is pre-revenueMy venture is post-revenue

How would you describe what your venture is offering to the market?

A science, tech based, or software productHealth Innovation

What is the name of your venture?

If your venture has a website please enter the URL :

If your venture has a LinkedIn Profile please enter the URL :

Tell us (briefly) about your venture - its products, services, solutions, and/or innovations:

Tell us (briefly) about who your customers are and what market will be interested in your product, service, solution, and/or innovation:

Please attach any files that would help us learn more about your company such as a pitch deck, business model canvas, or brochures or other literature about your business.

What type of help or assistance would you like to receive to help your venture grow?

Goals

Please list up to 3 goals that you would like your venture to achieve in the next 6-12 months?

Goal #1

Goal #2

Goal #3

Additional Information

By submitting this application on behalf of the venture named herein, the applicant hereby agrees that if this application is successful the venture shall participate in all programs and services, when recommended by QPI, including acceleration programs (depending on space and eligibility), workshops, networking events, etc.

Privacy

Privacy and Personal Information

Queen's University collects personal information under the authority of the Royal Charter of Queen's University and in accordance with Ontario’s Freedom of Information and Protection of Privacy Act (FIPPA). Queen’s University collects only the personal information which is necessary for it to administer its programs and activities and carry out its services and functions . The personal information is used by employees of the University who need the information to carry out their duties for the purposes for which it was collected or for a consistent purpose. Personal information is retained only as long as is necessary for the fulfillment of the purposes for which it is collected. The University has in place mechanisms to protect the security of the personal information it collects.

What is Personal Information?

'Personal Information' is defined in FIPPA as recorded information about an identifiable individual. An individual's personal information includes information regarding his or her race, gender, home address, medical history, education history, identifying numbers (e.g. SIN, employee number, student number, etc.), financial or employment information, personal opinions, completed assignments and exams, and grades, comments and evaluations provided by an instructor.

If you have a concern about the collection, use or disclosure of your personal information at Queen's University, please contact the Chief Privacy Officer, Carolyn Heald at access.privacy@queensu.ca.

Contact Information