Hello! We're excited to learn more about you.
First Name
Last Name
Email Address
Company Name
Location – City, State, and Country
Share Your Story
If available, please upload your Pitch Deck or Executive Summary.
Pitch Deck or Executive Summary
Don't have a deck? No problem!
Please provide a detailed description of your business in the space below.
Business Description
Business Priorities – What are the key goals, milestones, or focus areas for your business over the next 6–12 months?
What is the stage of your tech? Check all that apply.
Proof of Concept
Prototype Complete
Prototype in Progress
Patent Complete
Patent Pending
MVP
Other:
Other stage:
Program Expectations – How do you hope to benefit from participating in a LACI Program? How can we best support your growth?
Referral Source – How did you hear about LACI?
Friend or Colleague
Social Media
LACI Partner
Newsletter
Attended an Info Session
LACI Employee
Which LACI partner referred you?
Which LACI employee referred you?
Contact Information