Application Form

Please fill out the form below to submit your information to Empowered Startups.

The information you provide in this submission serves as your opportunity to convince Empowered Startups, that you are an entrepreneur with high-potential and expertise to build an amazing new Canadian company.

Candidate Information

Name*

Country*

Address*

Gender*
 Male
 Female

What is your country of origin? *

If you hold multiple passports and / or citizenships, please list all countries separated by commas.

Explain what expertise make you a high-performing entrepreneur.*

Summarize your educational background.*

What is the highest level of education you have completed?*

 High School  College Diploma  Undergraduate Degree  PhD or Doctorate Post-Doctorate  No formal education completed

Please describe your previous work history, including any relevant startup experience.*

If you are an international applicant, we only consider your application if you provide us with IELTS or CELPIP English language results

 Yes, I have written an International English Testing System or CELPIP exam  No, I have not written an International English Testing System or CELPIP exam

If yes, what date did you write?

If yes, what was your score?

Briefly describe your business venture / concept and your product or service offering.*

Upload an initial business opportunity document (executive summary business plan) in Word or PDF. Two pages maximum. Pitch us your company or idea.*

Where do you prefer incubation / acceleration?*

 Vancouver  Whistler