Fierce Founders Uplift Application

Communitech Fierce Founders Uplift Application

We're thrilled you're interested in joining Communitech's Fierce Founders Uplift program!

The application is designed to help us understand more about you and your company. It's intended to provide us with information to determine if the Uplift program is the right fit for you. If you are selected to move onto the interview stage, we will reach out to you directly.

*Please note additional documents may be requested as part of the selection process

Company Contact Information

Company Name *

Please enter a company name.

Company Website

Please enter your company website.

Company Address *

Please enter a street address.

Please enter a city.

Please enter a province.

Please enter a country.

Please enter a postal code.

Are you currently a Communitech member?

Yes

Please select a response.

Is your company incorporated in Canada? *

Yes

Please select a response.

Founder Information

Please enter the following information for the women and/or non-binary founder or co-founder.

First Name *

Please enter a first name.

Last name *

Please enter a last name.

Pronouns

Please enter your pronouns.

Role *

Please enter role.

Phone number *

Please enter a valid phone number.

Email *

Please enter your email.

Growth Plan

The Fierce Founders UpLift program is completely customizable and founder-focused. You'll work with a Growth Coach to create an individual growth plan to help you reach your goals and hit key milestones.

Please provide a summary of the goal you are looking to achieve during the program. *

Please enter your response.

What resources (people, tools, etc) are needed to achieve your growth plan? *

Please enter your response.

What activities do you plan to spend the funds you receive on? ($10K) *

Please enter your response.

How will you measure the success of your growth plan? *

Please enter your response.

Self-Identification

Please enter the following information for the founder or co-founder applying to the UpLift program. This information will be used to: 1) Assess self-identification with one of the equity-seeking groups the program intends to support. This program was created to help uplift women and non-binary founders from equity-deserving groups. 2) Communitech may use aggregate, non-identifiable information for public reports and to improve its services. If you wish to not answer some of the questions below that is more than okay. Please note that to receive the $10K non-matching funds, you must be a founder that is a woman or non-binary founder from an equity deserving group.

How would you describe your gender identity?

Please enter your response.

What race(s) and/or ethnicities do you identify with?

Please enter your response.

Do you identify as being a member of an indigenous community?

Please enter your response.

Do you identify as a person with a visible or invisible disability or disabilities?

Please enter your response.

Do you identify as a member of the 2SLGBTQIA+ community?

Please enter your response.

How did you hear about Fierce Founders Uplift? *

Please enter your response.

By submitting this form, you acknowledge you may be contacted about Communitech and Fierce Founders.

Communitech Fierce Founders Uplift Application

Company Contact Information

Founder Information

Company Information

Growth Plan

Self-Identification