Apply Form - Fintech Sandbox

Your contact info

First Name

Last Name

Work Phone

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Work Email

Personal Email

Select preferred email address:

WorkPersonal

Tell us about yourself

Professional Title/Role (e.g. Founder/CEO, CTO, etc.)

Tell us a little about yourself (100 words or less!)

Personal LinkedIn URL

Personal Twitter URL

Are you the primary contact for your company?

YesNo

Primary contact details

First Name

Last Name

Email

Phone

Professional Title

Personal LinkedIn URL

Personal Twitter URL

We value your privacy! FinTech Sandbox understands the importance of your privacy. Review our terms of use agreement which covers the personal information you are submitting.

Yes, I agree – we’ll process your informationNo, I do not agree – we’ll cancel your application, your data will not be saved.

Your company contact info

Company Name

Country

Company Street Address

City/Province

State

Postal Code

Your team (include all Co-Founders)

First Name

Last Name

Title

LinkedIn Profile

Phone

Email

More about your team

Indicate if your company’s leadership (founders and C-Suite) includes any of the following self-selected categories:

WomenRacial/ethnic minority groupsVeteransDisabled personsLGBTQIA+None of the aboveOther (please specify)This question is voluntary. This information is kept strictly confidential. Your answer to this question will not be used for purposes of selection in the FinTech Sandbox program.

Other, Please Specify:

Number
of employees, consultants and/or interns:

Please enter a whole number

How many of these employees do you employ full-time?

Please enter a whole number

How many of these employees are engineers/technologists?

Please enter a whole number

Is the executive team (founders and C-Suite) dedicated to this effort full-time?

Tell us about your company

Incorporation Date

Incorporation State or Country

Do you have a company website?

YesNo

Provide URL

Company
LinkedIn URL

Company Twitter URL

Does your company have a Crunchbase profile?

Company Crunchbase URL

Provide your company description (1-2 concise sentences. If you’re accepted, this information will be used on marketing materials and sent to partners.)

What
product(s) or service(s) does your company offer?

What unmet need does your product fill in the marketplace?

Select the FinTech sector that best describes your product and business.

Does your company focus on Sustainable & Inclusive Finance?

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