ECCI ACCELERATOR (STAGE 1) PROGRAMME

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1. ABOUT YOU
Page 1 of 8

 

1. Title: *

 

2. Full name: *

 

3. Company name *

 

4. Personal address (if applicable): *

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5. Your country of residence *

 

6. Business address (if different):

 

7. Business contact email (if applicable)

 

8. Business contact phone number (if applicable)

 

9. Company founder 1 (e.g owner, CEO) *

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10. Company founder 2 (e.g owner, CEO) (if applicable)

 

11. Tell us about your start up mission (max 100 words) *

 

12. Which theme is most applicable to you? *