Name * Contact No. (WhatsApp) * Email Address * Gender * Select One Male Female Transgender Gender Neutral non-binary Other Prefer not to say City of Residence * Country of Residence * Select One Afghanistan Albania Algeria American Samoa Andorra Angola Anguilla Antarctica Antigua and Barbuda Argentina Armenia Aruba Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia (Plurinational State of) Bonaire, Saint Eustatius and Saba Bosnia and Herzegovina Botswana Bouvet Island Brazil British Indian Ocean Territory Brunei Darussalam Bulgaria Burkina Faso Burundi Cabo Verde Cambodia Cameroon Canada Cayman Islands Central African Republic Chad Chile China Christmas Island Cocos (Keeling) Islands Colombia Comoros Congo Congo (Democratic Republic of the) Cook Islands Costa Rica Croatia Cuba Curaçao Cyprus Czech Republic Côte d'Ivoire Denmark Djibouti Dominica Dominican Republic Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Eswatini (Kingdom of) Ethiopia Falkland Islands (Malvinas) Faroe Islands Fiji Finland France French Guiana French Polynesia French Southern Territories Gabon Gambia Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guadeloupe Guam Guatemala Guernsey Guinea Guinea-Bissau Guyana Haiti Heard Island and McDonald Islands Honduras Hong Kong Hungary Iceland India Indonesia Iran (Islamic Republic of) Iraq Ireland (Republic of) Isle of Man Israel Italy Jamaica Japan Jersey Jordan Kazakhstan Kenya Kiribati Korea (Democratic People's Republic of) Korea (Republic of) Kosovo Kuwait Kyrgyzstan Lao People's Democratic Republic Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Macao Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Martinique Mauritania Mauritius Mayotte Mexico Micronesia (Federated States of) Moldova (Republic of) Monaco Mongolia Montenegro Montserrat Morocco Mozambique Myanmar Namibia Nauru Nepal Netherlands New Caledonia New Zealand Nicaragua Niger Nigeria Niue Norfolk Island North Macedonia (Republic of) Northern Mariana Islands Norway Oman Pakistan Palau Palestine (State of) Panama Papua New Guinea Paraguay Peru Philippines Pitcairn Poland Portugal Puerto Rico Qatar Romania Russian Federation Rwanda Réunion Saint Barthélemy Saint Helena, Ascension and Tristan da Cunha Saint Kitts and Nevis Saint Lucia Saint Martin (French part) Saint Pierre and Miquelon Saint Vincent and the Grenadines Samoa San Marino Sao Tome and Principe Saudi Arabia Senegal Serbia Seychelles Sierra Leone Singapore Sint Maarten (Dutch part) Slovakia Slovenia Solomon Islands Somalia South Africa South Georgia and the South Sandwich Islands South Sudan Spain Sri Lanka Sudan Suriname Svalbard and Jan Mayen Sweden Switzerland Syrian Arab Republic Taiwan, Republic of China Tajikistan Tanzania (United Republic of) Thailand Timor-Leste Togo Tokelau Tonga Trinidad and Tobago Tunisia Turkey Turkmenistan Turks and Caicos Islands Tuvalu Uganda Ukraine United Arab Emirates United Kingdom of Great Britain and Northern Ireland United States Minor Outlying Islands United States of America Uruguay Uzbekistan Vanuatu Vatican City State Venezuela (Bolivarian Republic of) Vietnam Virgin Islands (British) Virgin Islands (U.S.) Wallis and Futuna Western Sahara Yemen Zambia Zimbabwe Åland Islands Education Level * Select one Life Experience 12 years of schooling 14 years – Associate 16 Years – Undergraduate/Bachelor's 18 Years – Graduate/Masters 20 Years – MPhil 22 Years+ – PhD
Select the level of formal education, either online or offline
Experience Section Your Work Experiences * Select One No Experience Less then 3 Years 3 to 9 Years 10 to 15 Years 16 to 20 Years 20+ Years
Please select the number of years in full-time equivalent. For example, if you worked half the time for one year, that will be equivalent to six months full-time. Use 25% for internship work.
What can you do for a startup? * Select Your Choices Accounting and Finance Coding and Programming Content Development Data Management Legal and Law Product Planning and Design Product Engineering Research Sales and Marketing Startup Tools and Practices
Please select all your skills. Please do not overestimate yourself and select only areas where you have at least six months or more hands-on experience.
Industry Expertise * Select Your Choices I don't have in-depth experience in any industry 1111 Oilseed and Grain Farming 1112 Vegetable and Melon Farming 1113 Fruit and Tree Nut Farming 1114 Greenhouse, Nursery, and Floriculture Production 1119 Other Crop Farming 1121 Cattle Ranching and Farming 1122 Hog and Pig Farming 1123 Poultry and Egg Production 1124 Sheep and Goat Farming 1125 Aquaculture 1129 Other Animal Production 1131 Timber Tract Operations 1132 Forest Nurseries and Gathering of Forest Products 1133 Logging 1141 Fishing 1142 Hunting and Trapping 1151 Support Activities for Crop Production 1152 Support Activities for Animal Production 1153 Support Activities for Forestry 2111 Oil and Gas Extraction 2121 Coal Mining 2122 Metal Ore Mining 2123 Nonmetallic Mineral Mining and Quarrying 2131 Support Activities for Mining 2211 Electric Power Generation, Transmission and Distribution 2212 Natural Gas Distribution 2213 Water, Sewage and Other Systems 2361 Residential Building Construction 2362 Nonresidential Building Construction 2371 Utility System Construction 2372 Land Subdivision 2373 Highway, Street, and Bridge Construction 2379 Other Heavy and Civil Engineering Construction 2381 Foundation, Structure, and Building Exterior Contractors 2382 Building Equipment Contractors 2383 Building Finishing Contractors 2389 Other Specialty Trade Contractors 3111 Animal Food Manufacturing 3112 Grain and Oilseed Milling 3113 Sugar and Confectionery Product Manufacturing 3114 Fruit and Vegetable Preserving and Specialty Food Manufacturing 3115 Dairy Product Manufacturing 3116 Animal Slaughtering and Processing 3117 Seafood Product Preparation and Packaging 3118 Bakeries and Tortilla Manufacturing 3119 Other Food Manufacturing 3121 Beverage Manufacturing 3122 Tobacco Manufacturing 3131 Fiber, Yarn, and Thread Mills 3132 Fabric Mills 3133 Textile and Fabric Finishing and Fabric Coating Mills 3141 Textile Furnishings Mills 3149 Other Textile Product Mills 3151 Apparel Knitting Mills 3152 Cut and Sew Apparel Manufacturing 3159 Apparel Accessories and Other Apparel Manufacturing 3161 Leather and Hide Tanning and Finishing 3162 Footwear Manufacturing 3169 Other Leather and Allied Product Manufacturing 3211 Sawmills and Wood Preservation 3212 Veneer, Plywood, and Engineered Wood Product Manufacturing 3219 Other Wood Product Manufacturing 3221 Pulp, Paper, and Paperboard Mills 3222 Converted Paper Product Manufacturing 3231 Printing and Related Support Activities 3241 Petroleum and Coal Products Manufacturing 3251 Basic Chemical Manufacturing 3252 Resin, Synthetic Rubber, and Artificial Synthetic Fibers and Filaments Manufacturing 3253 Pesticide, Fertilizer, and Other Agricultural Chemical Manufacturing 3254 Pharmaceutical and Medicine Manufacturing 3255 Paint, Coating, and Adhesive Manufacturing 3256 Soap, Cleaning Compound, and Toilet Preparation Manufacturing 3259 Other Chemical Product and Preparation Manufacturing 3261 Plastics Product Manufacturing 3262 Rubber Product Manufacturing 3271 Clay Product and Refractory Manufacturing 3272 Glass and Glass Product Manufacturing 3273 Cement and Concrete Product Manufacturing 3274 Lime and Gypsum Product Manufacturing 3279 Other Nonmetallic Mineral Product Manufacturing 3311 Iron and Steel Mills and Ferroalloy Manufacturing 3312 Steel Product Manufacturing from Purchased Steel 3313 Alumina and Aluminum Production and Processing 3314 Nonferrous Metal (except Aluminum) Production and Processing 3315 Foundries 3321 Forging and Stamping 3322 Cutlery and Handtool Manufacturing 3323 Architectural and Structural Metals Manufacturing 3324 Boiler, Tank, and Shipping Container Manufacturing 3325 Hardware Manufacturing 3326 Spring and Wire Product Manufacturing 3327 Machine Shops; Turned Product; and Screw, Nut, and Bolt Manufacturing 3328 Coating, Engraving, Heat Treating, and Allied Activities 3329 Other Fabricated Metal Product Manufacturing 3331 Agriculture, Construction, and Mining Machinery Manufacturing 3332 Industrial Machinery Manufacturing 3333 Commercial and Service Industry Machinery Manufacturing 3334 Ventilation, Heating, Air-Conditioning, and Commercial Refrigeration Equipment Manufacturing 3335 Metalworking Machinery Manufacturing 3336 Engine, Turbine, and Power Transmission Equipment Manufacturing 3339 Other General Purpose Machinery Manufacturing 3341 Computer and Peripheral Equipment Manufacturing 3342 Communications Equipment Manufacturing 3343 Audio and Video Equipment Manufacturing 3344 Semiconductor and Other Electronic Component Manufacturing 3345 Navigational, Measuring, Electromedical, and Control Instruments Manufacturing 3346 Manufacturing and Reproducing Magnetic and Optical Media 3351 Electric Lighting Equipment Manufacturing 3352 Household Appliance Manufacturing 3353 Electrical Equipment Manufacturing 3359 Other Electrical Equipment and Component Manufacturing 3361 Motor Vehicle Manufacturing 3362 Motor Vehicle Body and Trailer Manufacturing 3363 Motor Vehicle Parts Manufacturing 3364 Aerospace Product and Parts Manufacturing 3365 Railroad Rolling Stock Manufacturing 3366 Ship and Boat Building 3369 Other Transportation Equipment Manufacturing 3371 Household and Institutional Furniture and Kitchen Cabinet Manufacturing 3372 Office Furniture (including Fixtures) Manufacturing 3379 Other Furniture Related Product Manufacturing 3391 Medical Equipment and Supplies Manufacturing 3399 Other Miscellaneous Manufacturing 4231 Motor Vehicle and Motor Vehicle Parts and Supplies Merchant Wholesalers 4232 Furniture and Home Furnishing Merchant Wholesalers 4233 Lumber and Other Construction Materials Merchant Wholesalers 4234 Professional and Commercial Equipment and Supplies Merchant Wholesalers 4235 Metal and Mineral (except Petroleum) Merchant Wholesalers 4236 Household Appliances and Electrical and Electronic Goods Merchant Wholesalers 4237 Hardware, and Plumbing and Heating Equipment and Supplies Merchant Wholesalers 4238 Machinery, Equipment, and Supplies Merchant Wholesalers 4239 Miscellaneous Durable Goods Merchant Wholesalers 4241 Paper and Paper Product Merchant Wholesalers 4242 Drugs and Druggists' Sundries Merchant Wholesalers 4243 Apparel, Piece Goods, and Notions Merchant Wholesalers 4244 Grocery and Related Product Merchant Wholesalers 4245 Farm Product Raw Material Merchant Wholesalers 4246 Chemical and Allied Products Merchant Wholesalers 4247 Petroleum and Petroleum Products Merchant Wholesalers 4248 Beer, Wine, and Distilled Alcoholic Beverage Merchant Wholesalers 4249 Miscellaneous Nondurable Goods Merchant Wholesalers 4251 Wholesale Electronic Markets and Agents and Brokers 4411 Automobile Dealers 4412 Other Motor Vehicle Dealers 4413 Automotive Parts, Accessories, and Tire Stores 4421 Furniture Stores 4422 Home Furnishings Stores 4431 Electronics and Appliance Stores 4441 Building Material and Supplies Dealers 4442 Lawn and Garden Equipment and Supplies Stores 4451 Grocery Stores 4452 Specialty Food Stores 4453 Beer, Wine, and Liquor Stores 4461 Health and Personal Care Stores 4471 Gasoline Stations 4481 Clothing Stores 4482 Shoe Stores 4483 Jewelry, Luggage, and Leather Goods Stores 4511 Sporting Goods, Hobby, and Musical Instrument Stores 4512 Book Stores and News Dealers 4521 Department Stores 4529 Other General Merchandise Stores 4531 Florists 4532 Office Supplies, Stationery, and Gift Stores 4533 Used Merchandise Stores 4539 Other Miscellaneous Store Retailers 4541 Electronic Shopping and Mail-Order Houses 4542 Vending Machine Operators 4543 Direct Selling Establishments 4811 Scheduled Air Transportation 4812 Nonscheduled Air Transportation 4821 Rail Transportation 4831 Deep Sea, Coastal, and Great Lakes Water Transportation 4832 Inland Water Transportation 4841 General Freight Trucking 4842 Specialized Freight Trucking 4851 Urban Transit Systems 4852 Interurban and Rural Bus Transportation 4853 Taxi and Limousine Service 4854 School and Employee Bus Transportation 4855 Charter Bus Industry 4859 Other Transit and Ground Passenger Transportation 4861 Pipeline Transportation of Crude Oil 4862 Pipeline Transportation of Natural Gas 4869 Other Pipeline Transportation 4871 Scenic and Sightseeing Transportation, Land 4872 Scenic and Sightseeing Transportation, Water 4879 Scenic and Sightseeing Transportation, Other 4881 Support Activities for Air Transportation 4882 Support Activities for Rail Transportation 4883 Support Activities for Water Transportation 4884 Support Activities for Road Transportation 4885 Freight Transportation Arrangement 4889 Other Support Activities for Transportation 4911 Postal Service 4921 Couriers and Express Delivery Services 4922 Local Messengers and Local Delivery 4931 Warehousing and Storage 5111 Newspaper, Periodical, Book, and Directory Publishers 5112 Software Publishers 5121 Motion Picture and Video Industries 5122 Sound Recording Industries 5151 Radio and Television Broadcasting 5152 Cable and Other Subscription Programming 5171 Wired Telecommunications Carriers 5172 Wireless Telecommunications Carriers (except Satellite) 5174 Satellite Telecommunications 5179 Other Telecommunications 5182 Data Processing, Hosting, and Related Services 5191 Other Information Services 5211 Monetary Authorities-Central Bank 5221 Depository Credit Intermediation 5222 Nondepository Credit Intermediation 5223 Activities Related to Credit Intermediation 5231 Securities and Commodity Contracts Intermediation and Brokerage 5232 Securities and Commodity Exchanges 5239 Other Financial Investment Activities 5241 Insurance Carriers 5242 Agencies, Brokerages, and Other Insurance Related Activities 5251 Insurance and Employee Benefit Funds 5259 Other Investment Pools and Funds 5311 Lessors of Real Estate 5312 Offices of Real Estate Agents and Brokers 5313 Activities Related to Real Estate 5321 Automotive Equipment Rental and Leasing 5322 Consumer Goods Rental 5323 General Rental Centers 5324 Commercial and Industrial Machinery and Equipment Rental and Leasing 5331 Lessors of Nonfinancial Intangible Assets (except Copyrighted Works) 5411 Legal Services 5412 Accounting, Tax Preparation, Bookkeeping, and Payroll Services 5413 Architectural, Engineering, and Related Services 5414 Specialized Design Services 5415 Computer Systems Design and Related Services 5416 Management, Scientific, and Technical Consulting Services 5417 Scientific Research and Development Services 5418 Advertising, Public Relations, and Related Services 5419 Other Professional, Scientific, and Technical Services 5511 Management of Companies and Enterprises 5611 Office Administrative Services 5612 Facilities Support Services 5613 Employment Services 5614 Business Support Services 5615 Travel Arrangement and Reservation Services 5616 Investigation and Security Services 5617 Services to Buildings and Dwellings 5619 Other Support Services 5621 Waste Collection 5622 Waste Treatment and Disposal 5629 Remediation and Other Waste Management Services 6111 Elementary and Secondary Schools 6112 Junior Colleges 6113 Colleges, Universities, and Professional Schools 6114 Business Schools and Computer and Management Training 6115 Technical and Trade Schools 6116 Other Schools and Instruction 6117 Educational Support Services 6211 Offices of Physicians 6212 Offices of Dentists 6213 Offices of Other Health Practitioners 6214 Outpatient Care Centers 6215 Medical and Diagnostic Laboratories 6216 Home Health Care Services 6219 Other Ambulatory Health Care Services 6221 General Medical and Surgical Hospitals 6222 Psychiatric and Substance Abuse Hospitals 6223 Specialty (except Psychiatric and Substance Abuse) Hospitals 6231 Nursing Care Facilities (Skilled Nursing Facilities) 6232 Residential Intellectual and Developmental Disability, Mental Health, and Substance Abuse Facilities 6233 Continuing Care Retirement Communities and Assisted Living Facilities for the Elderly 6239 Other Residential Care Facilities 6241 Individual and Family Services 6242 Community Food and Housing, and Emergency and Other Relief Services 6243 Vocational Rehabilitation Services 6244 Child Day Care Services 7111 Performing Arts Companies 7112 Spectator Sports 7113 Promoters of Performing Arts, Sports, and Similar Events 7114 Agents and Managers for Artists, Athletes, Entertainers, and Other Public Figures 7115 Independent Artists, Writers, and Performers 7121 Museums, Historical Sites, and Similar Institutions 7131 Amusement Parks and Arcades 7132 Gambling Industries 7139 Other Amusement and Recreation Industries 7211 Traveler Accommodation 7212 RV (Recreational Vehicle) Parks and Recreational Camps 7213 Rooming and Boarding Houses 7223 Special Food Services 7224 Drinking Places (Alcoholic Beverages) 7225 Restaurants and Other Eating Places 8111 Automotive Repair and Maintenance 8112 Electronic and Precision Equipment Repair and Maintenance 8113 Commercial and Industrial Machinery and Equipment (except Automotive and Electronic) Repair and Maintenance 8114 Personal and Household Goods Repair and Maintenance 8121 Personal Care Services 8122 Death Care Services 8123 Drycleaning and Laundry Services 8129 Other Personal Services 8131 Religious Organizations 8132 Grantmaking and Giving Services 8133 Social Advocacy Organizations 8134 Civic and Social Organizations 8139 Business, Professional, Labor, Political, and Similar Organizations 8141 Private Households 9211 Executive, Legislative, and Other General Government Support 9221 Justice, Public Order, and Safety Activities 9231 Administration of Human Resource Programs 9241 Administration of Environmental Quality Programs 9251 Administration of Housing Programs, Urban Planning, and Community Development 9261 Administration of Economic Programs 9271 Space Research and Technology 9281 National Security and International Affairs
Please select as many as many you have experienced with. Industry expertise are critical to the success of a B2B startup. Please do not overestimate yourself and select only sectors where you have at least three years or more experience.
Role in the Startup Section What role you are expecting in a startup? * Select Your Cohices Advisory Board Member (2 to 3 hours a week average) Founder or Co-Founder (20 hours per week to full-time) Investment Deal Broker (helping in finding investors in my own prodessional network) Industry Expert or Subject Matter Expert (as and when needed) Leadership Coach (Few hours a month) Lead Generator (provice potential customer leads) Mentor (Mentoring is always pro-bono work) Service Provider (as and when needed for specific deliverables) Social Amplifier (Promote startups on social media and through my network)
Multiple selection, select all that applies to you.
Your Time Availability for This Program * Select One Full Time 0 to 5 hours per week 5 to 10 hours per week 10 to 20 hours per week Only when needed to deliver on specific tasks Your Runway, how long can you work without salary? * Select One Few weeks to few months I can support myself while helping the startups on the side Up to six months Up to 12 months Up to 24 months Are you ready to relocate in case needed? * Select One Yes No I am open but it depends Confirmation *
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