INCUBATION CENTRE
STARTUP REGISTRATION FORM
Section A: Startup Details:
Startup Name:
1. Logo (if available): [paste here]
2. Date of Establishment: __________________________
3. Startup Type (Tick one):
o Proprietorship
o Partnership
o LLP
o Private Limited Company
o Others: _______________
4. Sector/Industry: _______________________________
5. Brief Description of Startup:
6. Website (if any): _____________________________
7. Funding Status:
o Bootstrapped
o Seed Funded
o Series A/B/C
o Looking for Funding
8. Start-up Stage (Tick one)
o Idea
o Prototype
o MVP Ready
o Revenue Generating
o Investment (Stages ?)
1
Section B: Founders' Details
Founder 1
• Full Name: _______________________________________
• Registration No. / Employee ID: _________________
• Department & Year: _______________________________
• Contact Number: ___________________
• Email ID: _________________________
Founder 2 (if applicable)
• Full Name: _______________________________________
• University Roll No. / Employee ID: _________________
• Department & Year: _______________________________
• Contact Number: ___________________
• Email ID: _________________________
(Add more founders if needed)
Team & Key Advisors/Mentors
Name Proposed Designation Qualifications Experience Key Skills
Summary
Section C: Incubation Requirements& Summary
1. What support are you seeking from the Incubation Centre?
(Tick all that apply)
o Office Space
o Mentorship
o Networking Opportunities
o Technical Support
o Legal/IPR Support
o Funding/Investor Connect
o Others: ___________________
2. Do you need seed funding from the Institute?
o Yes 2
o No
If yes, mention approximate amount: ₹_________
3. Executive Summary
Provide a brief overview of the startup idea. Summarize the problem your startup
addresses, your solution, the target market, and how incubation support will help. Keep it
concise and clear.
o Startup Idea/Concept:
[A one-liner description of your startup]
o Startup Vision:
[Describe the long-term vision for your startup]
o Startup Mission:
[Describe the long-term Mission for your startup]
4. Problem Statement
Clearly define the problem you are addressing:
o Current Problem:
[What is the gap or pain point in the market?]
o Existing Solutions/Alternatives:
[What are the existing solutions, if any? Why are they inadequate?]
o Impact of the Problem:
[How widespread or significant is this problem?]
5. Solution
Provide a detailed description of your solution:
o Product/Service Description:
[What are you offering? Explain the product or service in detail]
o Unique Value Proposition (UVP):
[What makes your solution unique or better than the alternatives?]
o Key Features:
[List the main features or benefits of your product/service]
o Technology/Innovation:
[If applicable, explain the technology or innovation behind your solution]
6. Market Research and Target Audience
Outline your target market and customer profile:
o Target Audience:
[Who is your primary customer? Define the demographic or niche you're targeting]
3
o Market Size:
[Provide data or estimates on the size of the market you are targeting]
o Competitor Analysis:
[Who are your key competitors? What are their strengths and weaknesses?]
o Market Trends:
[Highlight any trends or future opportunities in this market]
7. Business Model
Explain how your startup will make money and operate sustainably:
o Revenue Model:
[How will you generate revenue? E.g., product sales, subscription model,
advertisements, etc.]
o Pricing Strategy:
[What is the pricing of your product/service?]
o Cost Structure:
[List the major costs involved in developing and running the startup]
o Customer Acquisition:
[How will you attract and retain customers? What is your marketing strategy?]
8. Go-to-Market Strategy
Explain how you plan to launch your product/service:
o Launch Plan:
[How will you bring your product to market?]
o Distribution Channels:
[Which channels will you use to reach your customers?]
o Marketing and Promotion:
[What are your marketing and promotional tactics?]
9. Development Roadmap
Present the development milestones and timeline for your startup:
o Current Stage:
[What stage is your startup at? Idea, prototype, MVP, etc.]
o Milestones:
[What key milestones have you already achieved?]
o Future Milestones:
[Break down your key metrics in 24 months plan. Current stage of product development &
plan for next 24 months, along with milestones targeted. Add Gantt Chart]
10. Conclusion
Summarize why your startup is a good fit for the incubation program in SRM IST Delhi-NCR Campus
4
Ghaziabad.
Declaration
I/we declare that the information provided above is true to the best of my/our knowledge. I/we agree to abide by the
rules and policies of the Incubation Centre - SRM IST Delhi-NCR Campus, Ghaziabad.
Signature(s): _____________________________
Date: ____________
--------------------------------------------------------For Office Use Only-----------------------------------------------------------
Forwarded by
Class Mentor HOD
(Name, Signature& Seal) (Name, Signature& Seal)
Verified by
Dr. Anna Alphy
Chief Technology Officer-Incubation Centre
Approved by
Dr. A. Geetha Bhavani Dr. R. P Mahapatra Dr. Sanjay Viswanathan
Dean-Research Dean Director
