Your contact info First Name Last Name Work Phone Enter number, no spaces Work Email Personal Email Select preferred email address: WorkPersonal Tell us about yourself Professional Title/Role (e.g. Founder/CEO, CTO, etc.) Tell us a little about yourself (100 words or less!) Personal LinkedIn URL Personal Twitter URL Are you the primary contact for your company? YesNo Primary contact details First Name Last Name Email Phone Professional Title Personal LinkedIn URL Personal Twitter URL We value your privacy! FinTech Sandbox understands the importance of your privacy. Review our terms of use agreement which covers the personal information you are submitting. Yes, I agree - we'll process your informationNo, I do not agree - we'll cancel your application, your data will not be saved. Your company contact info Company Name Country Please select...AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos ( Keeling ) IslandsColombiaComorosCongoCook IslandsCosta RicaCôte d ' IvoireCroatia ( Hrvatska )CubaCyprusCzech RepublicCongo ( DRC )DenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFalkland Islands ( Islas Malvinas )Faroe IslandsFiji IslandsFinlandFranceFrench GuianaFrench PolynesiaFrench Southern and Antarctic LandsGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHondurasHong Kong SARHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiKoreaKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacao SARMacedonia, Former Yugoslav Republic ofMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNetherlands AntillesNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPanamaPapua New GuineaParaguayPeruPhilippinesPitcairn IslandsPolandPortugalPuerto RicoQatarReunionRomaniaRussiaRwandaSamoaSan MarinoSão Tomé and PrìncipeSaudi ArabiaSenegalSerbia and MontenegroSeychellesSierra LeoneSingaporeSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSpainSri LankaSt. HelenaSt. Kitts and NevisSt. LuciaSt. Pierre and MiquelonSt. Vincent and the GrenadinesSudanSurinameSvalbard and Jan MayenSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUnited States Minor Outlying IslandsUruguayUzbekistanVanuatuVatican CityVenezuelaViet NamVirgin Islands ( British )Virgin IslandsWallis and FutunaYemenZambiaZimbabwe Company Street Address City/Province State Please select...AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict Of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingPuerto RicoVirgin IslandNorthern Mariana IslandsGuamAmerican SamoaPalau Postal Code Your team (include all Co-Founders) First Name Last Name Title LinkedIn Profile Phone Email More about your team Indicate if your company's leadership (founders and C-Suite) includes any of the following self-selected categories: WomenRacial/ethnic minority groupsVeteransDisabled personsLGBTQIA+None of the aboveOther (please specify)This question is voluntary. This information is kept strictly confidential. Your answer to this question will not be used for purposes of selection in the FinTech Sandbox program. Other, Please Specify: Number of employees, consultants and/or interns: Please enter a whole number How many of these employees do you employ full-time? Please enter a whole number How many of these employees are engineers/technologists? Please enter a whole number Is the executive team (founders and C-Suite) dedicated to this effort full-time? Please select...YesNo Tell us about your company Incorporation Date Incorporation State or Country Do you have a company website? YesNo Provide URL Company LinkedIn URL Company Twitter URL Does your company have a Crunchbase profile? Please select...YesNo Company Crunchbase URL Provide your company description (1-2 concise sentences. If you're accepted, this information will be used on marketing materials and sent to partners.) What product(s) or service(s) does your company offer? What unmet need does your product fill in the marketplace? Select the FinTech sector that best describes your product and business. Please select...Financial AccountingEnterprise InfrastructureCybersecurityAsset ManagementBusiness Lending & FinancingCapital Markets & Institutional TradingCore Banking & InfrastructureCredit Score & AnalyticsCryptocurrencyDigital BankingFinancial Services & AutomationGeneral Lending & MarketplacesInsuranceMobile Wallets & RemittancesMortgage LendingPayments Processing & NetworksPayroll & BenefitsPersonal Finance & SavingsPOS & Consumer LendingReal EstateRegulatory & ComplianceRetail Investing & Secondary MarketsWealth Management Does your company focus on Sustainable & Inclusive Finance? Please select...Yes - focus on ESG transparencyYes - focus on climate/energyYes - focus on financial accessNo Page 3 Company Information Continued Have you developed an alpha product? Please select...YesNo An alpha product is a wireframe with a backend engine, it is not a powerpoint slide, a screen shot, or an excel spreadsheet. Select the technologies leveraged in your product: (Select all that apply) Artificial IntelligenceAutomation Big Data AnalyticsCryptocurrencyData Visualization Data Management Robo-advisory Machine Learning Virtual/Augmented l Reality High-Performance Computing Quantum ComputingNatural Language Processing Blockchain Dataset and Signal Creation Trading SystemsInternet of Things Other, please specify Other, please specify: What office does your product service? (Select all that apply) Front OfficeMiddle OfficeBack OfficeConsumer Who are your competitors? Why are you different? Select which model best describes your business: Please select...B2BB2CB2B2C Who are your target customers? (Select all that apply) Consumers/IndividualsConsulting Firms/Service ProvidersCommunity BanksData ProvidersLarge Financial InstitutionsMid-Sized Financial InstitutionsSmall Financial InstitutionsSmall BusinessesOther Other Target Customer - Please Specify List any startup accelerator or incubator program(s) that you have completed or are currently participating in: If you have not participated in any programs input "None" Have you obtained any paying customers since the launch of your company? Please select...YesNo If yes, how many? Please enter a whole number More about your company Current level of funding. Please select...BootstrappedAngelFriends and FamilyPre-seedSeedSeries ASeries BSeries CSeries DAcquired Money raised to date (be sure to enter amount in USD): Please enter a whole number, with no extra characters (i.e. $, , ) Monthly revenue (be sure to enter amount in USD): Please enter a whole number, with no extra characters (i.e. $, , ) How many POCs (Proof of Concepts) have you engaged in since the launch of your company? (Your response can be "0") Please enter a whole number What is your long-term growth plan for your company? Please select...Exit through acquisitionBecome a unicornBecome a strong private companySell to a friendly individualEventual IPOOther (please specify) Other, please specify FinTech Sandbox's Data Access Program Why do you want to join FinTech Sandbox's Data Access Program? What type(s) of data do you need? How do you plan to use the data during our 6 month program? What will you accomplish or develop? Share specific examples/details. Select which data partners you'd like to work with: 7ChordAbrigoAccuweatherACTIV FinancialArgyleAssociated PressAWSBarChartBenzingaBest Credit DataBoss InsightsCME GroupData Axle (Infogroup)Data SimplyDigital Financial LLCDow Jones NewsEdgar OnlineEnvestnet YodleeEquifaxEuromoneyExchange Data InternationalExtract AlphaFactSetFinancial Information Inc. (FII)FinMasonIntrinioMoody's AnalyticsMorningstarMorningstar - SustainalyticsMSCIPlaidQuandl/NASDAQQUODDS&P Dow Jones IndicesS&P Global MarketplaceSQXSustainalyticsTagnifiTiingoTradierTrasUnionXignite Share additional information you'd like us to consider: FinTech Sandbox's Data Access Program provides companies to access to data for development purposes only and is not for commercial use. Are you prepared to commit to these stipulations? YesNo Are you aware of and prepared to commit fully to our Give Back Agreement if accepted as a participant? YesNo How did you hear about FinTech Sandbox? Google searchPartner websiteColleague/friendData providerFinTech Sandbox team member FinTech Sandbox advisor or board memberCo-working spaceEventPress release/newsSocial media (LinkedIn/Twitter)YouTubeBlog postOther Referred by First Name Last Name Company Email You're about to submit your data to us! Review FinTech Sandbox's Startup Agreement and Privacy Policy which pertains to this application. By submitting this application, I agree to the FinTech Sandbox Startup Agreement Contact Information
