First name* Surname* Email* Phone Website / URL Country* Åland IslandsAfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelauBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Saint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCongo (Brazzaville)Congo (Kinshasa)Cook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyIvory CoastJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalestinian TerritoryPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarReunionRomaniaRussiaRwandaSão Tomé and PríncipeSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint Martin (Dutch part)Saint Martin (French part)Saint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia/Sandwich IslandsSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited Kingdom (UK)United States (US)United States (US) Minor Outlying IslandsUruguayUzbekistanVanuatuVaticanVenezuelaVietnamVirgin Islands (British)Virgin Islands (US)Wallis and FutunaWestern SaharaYemenZambiaZimbabwe What is your role in the business?* Founder/Joint founderC-SuiteMember of management teamEmployee
Company Name* Company Trading Name* Website* Year founded* Employee Headcount* Country of incorporation* Åland IslandsAfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelauBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Saint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCongo (Brazzaville)Congo (Kinshasa)Cook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyIvory CoastJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalestinian TerritoryPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarReunionRomaniaRussiaRwandaSão Tomé and PríncipeSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint Martin (Dutch part)Saint Martin (French part)Saint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia/Sandwich IslandsSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited Kingdom (UK)United States (US)United States (US) Minor Outlying IslandsUruguayUzbekistanVanuatuVaticanVenezuelaVietnamVirgin Islands (British)Virgin Islands (US)Wallis and FutunaWestern SaharaYemenZambiaZimbabwe
Please tell us about key people in your leadership team: we require at least one person please.
(1) Name* Title* LinkedIn URL* Experience level* First time member of managementSome previous management experienceSeasoned management experienceSeasoned management experience, previous notable exitSeasoned management experience, >2 previous notable exits (2) Name Title LinkedIn URL Experience level First time member of managementSome previous management experienceSeasoned management experienceSeasoned management experience, previous notable exitSeasoned management experience, >2 previous notable exits (3) Name Title LinkedIn URL Experience level First time member of managementSome previous management experienceSeasoned management experienceSeasoned management experience, previous notable exitSeasoned management experience, >2 previous notable exits
If you have one, please tell us about key members of your official advisory board or existing investors
(1) Name LinkedIn URL (2) Name LinkedIn URL (3) Name LinkedIn URL
What primary technology best categorises your business?* 3D Bio-printingAgetechBiomarkersAI for drug discoveryAI for other longevity applicationsClinical services for longevityCyberneticsNutraceuticalsDigital healthGene therapyImmunotherapyNanotechnologyNeural integrationOrgan growthSenolytic drug therapyXenotransplantationOther Other (please specify) What best describes your company's commercial status?* We're a university spinout with unique intellectual property (pre-patent)We're pre-revenueWe're early revenueWe're scaling-up revenueWe're looking to acquire Other (please specify)
Flagship product or solution name* Brief description* Target(s) hallmark of aging (if you have defined) Altered intracellular communicationCellular SenescenceDeregulated nutrient-sensingEpigenetic alterationsGenomic instabilityLoss of proteostasisMitochondrial dysfunctionStem cell exhaustionTelomere attrition(Recovery rate) Target disease/medical condition (if you have defined) Product commercial stage* ResearchDevelopmentClinical trialsCommercialMarket approvedEarly commercialGrowth commercial Patent/IP* We have unique IP (pre-patent)We have a patent application submittedWe have granted patent(s)We have a black box product/IPNot relevant to our business What age-related diseases/indications could benefit from this product? Altered intracellular communicationAlzheimer’s DiseaseArthritisCancerCardiovascular DiseaseCataractsCerebrovascular DiseaseCognitive agingDementiaDepressionDiabetesHearing lossHypertensionHearing lossMobilityOsteoarthritisOsteoporosisObesityParkinson’s Other (please specify) Has your product undergone clinical trials?* Yes - If yes answer next questionsNo, but we are planning to startNo, we have no plans for clinical trials Clinical trial stage of product Early discoveryPre-clinicalPhase IPhase IIPhase III Were the population in your clinical trials healthy or did they have a current condition? HealthyCurrent condition – please specify below Are you planning to advance the product to (possibly further) clinical trials? YesNoUndecided Other (please specify)
What funding stage is your company currently at?* Grant funded but looking to raise equity investmentPre-seed investmentCurrently seeking seed investmentSeed-funded, pre-series ACurrently raising series ASeries A funded, pre-series BCurrently raising series BSeries B funded, pre-series CCurrently raising series CMezzanine funded ahead of potential IPOCash positive: don't need to fundraise Other (please specify)
What is your target investment for your next investment round?* Below $0.5m$0.5m to $1m$1m to $5m$5m to $10m$10m to $30m$30m to $50m$50m+ Current Pre-money valuation if known: What is your total funding to date?* What share class are you offering?* Same class as founders (voting)Non-voting sharesOther When are you looking to close your round?* Now6 months1 year2 years
Company name or investor name Company name or investor name Company name or investor name What do you plan on doing with this raised capital?* ResearchDevelopmentClinical trialsSales and marketing scale-upRegulatory approvalAcquire IP or another companyOther
Current turnover / revenue?* What is your projected growth in revenues in next 12 months?* 0%5-10%11-30%31-50%51-70%71-100% When do you see any potential for exit (mergers/acquisitions/IPO) ?* 1-3 years3-5 years5-10 years10+N/A What is your go to market entry strategy? * Direct salesIndirect salesLicensingFranchisingPartnering Other (please specify)
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