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Prix Galien StartUp 2023 Application Form

General Information

Program/Fund Name Corporate Name Date Of Creation

Indications (if applicable) Therapeutic Categories (if applicable)

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History & Focus

History of the development of the fund / Incubators Focus

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VALUE PROPOSITION

How do you address your portfolio needs Impact / metrics to measure success

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INNOVATION

Why your model is innovative, and/or how it will improve the human condition?

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REFERENCES

Please provide appropriate references (Examples / Case Study)

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Please note that your submission will be available for viewing and editing from your dashboard on this platform until the date of submission closure.

Please note that only complete submissions will qualify for judging. Your submission will be available for editing from the dashboard until the date of submission closure.

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