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Orlando Tech Connect Program Enrollment

Please complete the form below to learn more about the Orlando Tech Council’s Tech Connect Program.

1 Company Information

2 Existing Client Reference(s)

3 Team Structure

4 Entrepreneurial Support Program Participation

Company Name*
Industry Sector*
Company Description*
Include a brief description of your business technology/product/service(s).
Business Address (if applicable)
Address Address Line 2 City State Zip Code
Contact First Name*
Contact Last Name*
Contact Phone Number*
Contact Email*
Target Market*
Who is your product or service directed to?

Client #1 | Company
Client #1 | Contact: First Name
Client #1 | Contact: Last Name
Client #1 | Contact: Email
Client #1 | May we contact?
- Yes
- No
Client #2 | Company
Client #2 | Contact: First Name
Client #2 | Contact: Last Name
Client #2 | Contact: Email
Client #2 | May we contact?
- Yes
- No
Client #3 | Company
Client #3 | Contact: First Name
Client #3 | Contact: Last Name
Client #3 | Contact: Email
Client #3 | May we contact?
- Yes
- No
Identify Regional Ideal Enterprise (Large Customer)
Identify Regional Ideal Enterprise (Large Customer)

Organizational Chart
Attach an organization chart or list key employees below.
Accepted file types: pdf, jpg, gif, png.
Key Employee
Name
Position
Key Employee
Name
Position
Key Employee
Name
Position
Key Employee
Name
Position
Key Employee
Name
Position
Key Employee
Name
Position
Key Employee
Name
Position
Key Employee
Name
Position

Which entrepreneurial support program have you participated in?
Choose ALL that apply:
- UCF Incubators
- Rise of the Rest Finalists
- Starter Studio (Seed Program)
- Rollins Venture Plan Finalists
- Venture Scale Up
- Guidewell Accelerator Program
- Rally
- Kirenaga
- DeepWork Capital
- Other
Other Entrepreneurial Support Program Participation:
Other Required Attachment: Sales Presentation*
Accepted file types: jpg, gif, png, pdf.
Other Required Attachment: Sales Collateral*
Accepted file types: jpg, gif, png, pdf.
Other Required Attachment: Executive Summary*
Accepted file types: jpg, gif, png, pdf.

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407.422.7159

301 E. Pine Street, Suite 900,Orlando, FL 32801

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