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2010 Ag Innovation Showcase Presenter Application Form

In order to be considered for the 2010 Ag Innovation Showcase, you must fill out and submit the following application. You must provide answers for all fields marked with "*". It is strongly recommended that you provide as much information as possible, as this will enable us to properly evaluate your application.

The 2010 Ag Innovation Showcase Application consists of three sections:
Section 1: General Information
Section 2: University Referral
Section 3: Company Assessment
Section 4: Company Description and Executive Summary

Section 1: General Information
1. Company Information *
Company:
Address 1:
Address 2:
City:
State:
Zip:
Country:
Url:
2. Company CEO or Person who will be Presenting *
First Name:
Last Name:
Title:
Email:
Phone:
Fax:
3. Contact Person for this Application *
First Name:
Last Name:
Title:
Email:
Phone:
4. Industry Sector (Please describe your company's major field of business) *
(Ag-Biotech, Food and Nutrition, Renewable Energy, Animal Health, etc.)
5. How many employees does the company have? *

6. How did you hear about the Ag Innovation Showcase? *

If you have chosen "Other" please specify:
7. What do you expect to gain? *
PartnersInvestors
Section 2: University Referral
1. Are you a university researcher or is your company a university spin-off? * YesNo
Which University?:
2. Please enter the name of the university technology transfer officer referring you:

Section 3: Company Assesment
Topic to be evaluated	Evaluation Criteria	Please briefly describe each aspect of your technology/business.
Technology Status
Description	Describe the core technology proposed for commercialization and its development status.
Strength	Assess the degree of advancement and strength of the technology.
Significance	Describe the potential impact on the selected markets.
Protection	Describe the IP protection plans and status along with any issued patents with significant blocking potential.
Market Vision
Market pain	Describe your anticipated market need and the degree of pain, i.e., must have vs nice to have.
Proposed solution	Describe your proposed product or service.
Differentiation	Assess the indirect and direct competition and the benefits.
Market/size	Address your proposed market and order of magnitude market size.
Business Vision
Readiness for Beta	State the timeline to the availability of beta prototypes for customer testing.
Business Model	Describe the nature of the business and how it will make money.
Funding	List the amount and sources of funding required to realize the business vision.
Management	Describe the management team needed to launch the business.

Section 4: Company Description and Executive Summary
1. Please provide a company description of no more than 100 words. If selected, this description will be used for the 2010 Ag Innovation Showcase Program Book. *

2. Please upload your executive summary *

Note: Submitting this form may take a few minutes to complete depending on the size of your executive summary. Please allow the form to finish processing completely to ensure your data gets saved correctly. Please try and limit your file to 5MB.

Non Disclosure: Except where specifically noted, all information you enter in the application process will be held in the strictest of confidence and Larta will not use, disclose or otherwise permit any person or entity access to any of the information other than as required in the performance of Larta's services for Company

PRESENTED BY: