Portland State University

SII Circuit Program Application

The Social Innovation Incubator (SII) Circuit Program is a six-month incubation program that seeks to help you become a leader of social change. Small group meetings every other week alternate between workshops delivered by local experts and facilitated peer-mentoring sessions. The program uses the Lean Startup methodology, Business Model Canvas, and customer discovery process to guide development of successful social enterprises.

Both students and community members are encouraged to apply. Applicants must have a social enterprise concept or existing venture, either for-profit or nonprofit, that uses business tools to address a major social or environmental problem such as poverty or its contributing factors.

The application process consists of two steps:

1. Apply by November 2, 2012 to attend the Business Model Workshop held November 16 from 7:30-10:30 a.m. This form is your application for the workshop. The workshop is your chance to get to know us, for us to meet you and for you to make real progress on your business model. You will be notified of your acceptance to the workshop by November 9.

Workshop cost: $25, payable at door.

2. Using a Business Model Canvas you develop in the workshop, apply for the 2013 Circuit Program. All regular workshops are scheduled for a Friday from 7:30–10:30 a.m. Up to two company founders are permitted at meetings, but one must commit to attending at least six of nine sessions, as well as the demo day, for your venture to graduate.

Subsidized circuit cost: $600, (about $20 per meeting hour) payable on acceptance or in two installments. Unlike other incubators, we take no equity stake in your business—you retain full control. And if that weren't enough, many meetings include food! Scholarships are available for students.

Calendar of Sessions:
Jan. 18, Feb. 15, Mar. 15, Apr. 12, May 10: expert-led workshop sessions
Feb. 1, Mar. 1, Apr. 26, May 24: Business Model Canvas and pitch practice sessions
June 21: Demo day

The Circuit Program sessions are in-depth and tailored to the needs of social entrepreneurs. With a team of coaches, mentors and like-minded entrepreneurs at your side, you'll learn about business law, planning and strategy, marketing and sales, financial estimates, impact measurement and other essential skills, all with an emphasis on the unique approach of social entrepreneurs. You'll walk away with new skills, the ability to pitch to investors, and a supportive network of peers and mentors.

NOTE: We are looking for SHORT answers to get to know you. Don't stress!

Contact Info
Your Name * First Last
All information entered in this form is confidential and will be shared only with Circuit Program planners and advisors. Your information will never be sold or used in advertising.
Your Email *

All information entered in this form is confidential and will be shared only with Circuit Program planners and advisors. Your information will never be sold or used in advertising.
Your Phone Number * ### - ### - ####
All information entered in this form is confidential and will be shared only with Circuit Program planners and advisors. Your information will never be sold or used in advertising.
Co-Founder #2 First Last
Co-Founder #3 First Last
Other co-founders/advisors/notable staff

"The Internet" is not an acceptable answer.
Concept
Business/org Name
Website
Please describe your business concept *
Maximum Allowed: 300 words. Currently Used: 0 words.

What is your main product/service, who are your customers, and how will you sell to them?
What social or environmental problems is your business designed to address, and how? *
Maximum Allowed: 200 words. Currently Used: 0 words.

In 200 words or less, please. It might not seem like much, but think of how many tweets that would be!
Please describe any experience you may have relevant to your business.
Maximum Allowed: 100 words. Currently Used: 0 words.

We need to know if you should be teaching the workshops instead of taking them.
What was your most interesting failure, and what did you learn from it?
Maximum Allowed: 100 words. Currently Used: 0 words.

If this is something truly inspiring/incredibly funny, we may ask you to share it at the workshop.
Status
What progress have you made in moving your business forward? *
Maximum Allowed: 100 words. Currently Used: 0 words.

For example, do you have a product prototype, signed customers, patent filing, etc.
Do you have:
A legal entity A business plan Outside funding An advisory board Any sales to date or signed contracts

Don't worry—none of these things are required for the workshop or Circuit Program. This just helps us tailor our approach.
If you have a legal entity, what type is it?
Maximum Allowed: 25 words. Currently Used: 0 words.

For example, C Corp, 501(c)(3), etc.
If you have outside funding, please describe the source.
Maximum Allowed: 25 words. Currently Used: 0 words.

Friends, family, fools, etc.
What's the largest challenge your business currently faces? *
Maximum Allowed: 100 words. Currently Used: 0 words.

If you're very lucky, your biggest current challenge is completing this form.
What do you hope to gain from the Circuit Program? *
Maximum Allowed: 100 words. Currently Used: 0 words.

Penultimate question!
If you are selected for the program, what are you committed to doing to create a positive experience for others and yourself? *
Maximum Allowed: 100 words. Currently Used: 0 words.

Last question!
Do Not Fill This Out

Portland State University

Contact Info

Concept

Status