Connecticut Innovations Funding Inquiry

General Company Information

Legal Company Name*

Contact Name*

First Last

Title*

Address

Street Address Address Line 2 ZIP / Postal Code

City, State and Country*

City/State and or Country

Email*

Phone

Business Plan/Pitch Deck Upload*

Max. file size: 50 MB.

Brief Description of Company or Product- What do they do?*

Founder,CEO and/or Owner are identified as: (check all that apply)

Is the company woman-owned?:*

Is the company veteran-owned?:*

Name of CI Contact

First Last