LEAP India Startup Summit 2023 - The Trailblazers Nomination Form

LEAP India Startup Summit 2023 - The Trailblazers Nomination Form
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"Get ready for the LEAP India Startup Summit 2023! The Trailblazers Nomination Form is now available for internal use only. Showcasing the best and brightest in the startup world, this summit is a must-attend event for industry leaders and innovators."

  • LEAP India
  • Startup Summit
  • Trailblazers
  • Nomination
  • Innovation

Uploaded on Mar 12, 2025 | 0 Views


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  1. LEAP India Startup Summit 2023 LEAP India Startup Summit 2023 Startup 50: The Trailblazers Nomination Form Internal Use Only

  2. SECTION A Key Guidelines Internal Use Only

  3. Key Instructions (1/2) Definition and Eligibility Criteria The term startup refers to a company which is in the early stages of operation. Startups are founded by one or more entrepreneurs who want to develop or improve a product, process or service and have a scalable business model with high potential for wealth creation and employment generation Business must be incorporated or commenced on or after January 1, 2013 Annual turnover of not exceeding INR 250 crore for any of the financial year since inception Entity should not have been formed by demerger or split or reconstruction of an existing business Key Instructions The Nomination form submitted will be evaluated for deciding Dun & Bradstreet Startup 50. These Entities will be felicitated at the Inauguration Edition of Dun & Bradstreet LEAP India Startup Summit 2023. Nomination forms with incomplete declaration details, with incomplete or inaccurate mandatory details or submitted without the specified mandatory documents are liable to be considered as incomplete and hence can be disqualified. Standalone financial statements for FY22, FY21, and FY20 are mandatory for the purpose of participation. The last date for submission of completed nomination forms is 12thMay 2023 There is NO participation fee for submitting the nomination form. Completed Nomination form along with all documents should be submitted to Dun & Bradstreet India via below mentioned email before the last date of receiving nomination forms. 3

  4. Key Instructions (2/2) Mandatory Documents Completed Nomination Form Certificate of Incorporation Audited Financial Statements (BS, P&L Account) for the last three financial years (FY22, FY21, FY20). Banker s Confidentiality Letter (BCL) Startup Pitch Deck explaining business model and other details of Excellence (Max. 12 Slides) Trade Specific Registration Details and Documents Strongly Recommended Documents Marketing Collaterals, Product Brochures, Company Brochures, Award/Quality Certifications Credit rating report/score 4

  5. SECTION B Build Your Case For Excellence (Mandatory Information) Internal Use Only

  6. Mandatory Information (1/3) Company Details Registered Company Name: Head Office City and State: Brand Name: Year of Incorporation: Website and App Details: Company Email: Shareholding Pattern Shareholder Name % Holding Shareholder Name % Holding Founder/Co-Founder Details Founder/Co-Founder Name Designation Email Id Contact No 6

  7. Mandatory Information (2/3) Kindly Identify the Practice Area (Industry) of your company Industries Yes/No Industries Yes/No Agriculture Energy - Food and Agriculture Tech - Generation & Distribution - Others (Please Specify) - Storage Manufacturing - Energy Tech - Industrial Goods & Manufacturing Financial Services - Consumer Goods - FinTech - Semiconductors - InsureTech - Others (Please Specify) - Others (Please Specify) Retail Health, Education and Wellness Life Sciences - HealthTech Telecom - EdTech Media and Entertainment - Others (Please Specify) Mining Gaming 7

  8. Mandatory Information (3/3) Kindly Identify the End User Industry of your product or solutions Industries Yes/No Industries Yes/No Real Estate & Construction Other Technology Solutions - Real Estate & Construction Tech - Enterprise Applications - Others (Please Specify) - Consumer Solutions Transport and Logistics - AI based Solutions - Transport and Logistics Tech - Blockchain - Others (Please Specify) - Enterprise Security Architecture Tours, Travel and Hospitality - Environment Tech - Tours, Travel and Hospitality Tech - Aerospace, Maritime and Defense Tech - Others (Please Specify) Others (Please Specify) Kindly clearly describe the business sector you are operating in, products delivered, or services rendered 8

  9. Build Your Case for Excellence (1/6) Kindly define and quantify the problem /need your start-up is attempting to solve *Please describe in not more than 1000 words 9

  10. Build Your Case for Excellence (2/6) Describe your business model that attempts to solve the stated problem/need Please provide details in note more than 1000 words about Key Description of your business model covering revenue plan, GTM, product plan and phasing along with key resources (example operating and technology resources) Key Products and Services (detailed description to support the revenue plan and segregation between current / new, planned, etc.) How the business model is solving the stated problem and the iterations (how has the model evolved?) 10

  11. Build Your Case for Excellence (3/6) Kindly highlight the Uniqueness, Key Differentiation, Competitive Advantage of your business? *Please describe not more than 1000 words covering specific aspects that are clear and quantifiable. Any supporting evidence provided will add credence to the submission 11

  12. Build Your Case for Excellence (4/6) Describe the stage of your Startup and How the funding need has evolved with progression of your business model? Please provide details about - Series of Funding (Bootstrap, Series A, Series B, Series C and so on) Total Funding Implicit Valuation / as per last funding Investor Details (You can send additional documents to email id provided below) Kindly provide Core Team Details of your company and their role in the business? Please provide details about - Core Team, Current Role and Designation, Education Background, Previous Work Experience, Technical or other Expertise making them suitable for the role Organization Structure (You can send additional documents to email id provided below) 12

  13. Build Your Case for Excellence (5/6) Kindly Describe Your Path To Profitability Kindly provide details your revenue and profitability trends over past few years Kindly provide details of roadmap to profitability and future growth 13

  14. Build Your Case for Excellence (6/6) Provide Additional Details Customers, Technology and any other operating resources *Please provide details such as Who are your customers/No of customers or active users/ Stickiness of your customers Current technology, solution stack, partnerships Trends in Cost of Delivery and future plans (Send additional documents to email id mentioned below) 14

  15. SECTION C Additional Information (These questions will not be considered for evaluation) Internal Use Only

  16. Additional Information (1/3) The questions under this section are for better insights that will shape the Indian Startup ecosystem in the next five years. The information collated will be used as insights for the sector in general. Participants can select multiple options while answering the following questions. What do you think are the key enabling factors that can contribute to the success of any startup in the next five Years Details Yes/No Details Yes/No Access to Funding and Investments Strong Customer-focused approach Innovative and scalable products / services Effective Marketing and Branding Strong Leadership and Management Strategic Partnerships and Collaborations Please Specify Others In your opinion, what are the biggest challenges facing Startups in India for the next five years Details Yes/No Details Yes/No Limited Access to Funding Changing Customer Preferences Rapidly Changing technology landscape Economic Uncertainty and Instability Regulatory Challenges Increased Competition Please Specify Others 16

  17. Additional Information (2/3) The questions under this section are for better insights that will shape the Indian Startup ecosystem in the next five years. The information collated will be used as insights for the sector in general. Participants can select multiple options while answering the following questions. In your opinion, which of the following skills is most important for a startup founder to possess Details Yes/No Details Yes/No Vision and Creativity Communication skills Problem-solving skills Resilience and perseverance Domain Specific Technical Skills Strategic Thinking Please Specify Others In your opinion, which of the following technologies do you believe has the most potential to disrupt the startup ecosystem in the next five years Details Yes/No Details Yes/No Artificial Intelligence/ Machine Learning Quantum Computing Blockchain Internet of Things 5G Networks Web 3.0 Please Specify Others 17

  18. Additional Information (3/3) The questions under this section are for better insights that will shape the Indian Startup ecosystem in the next five years. The information collated will be used as insights for the sector in general. Participants can select multiple options while answering the following questions. Which of the following trends do you believe will have the biggest impact on startups in the next five years Details Yes/No Details Yes/No Continued growth of the gig economy and freelance workforce Shift towards subscription-based business models Remote work and distributed teams Increased focus on sustainability and social responsibility Please Specify Others 18

  19. SECTION D Declaration (Mandatory Information) Internal Use Only

  20. Declaration (Mandatory Information) This is to certify that all information in nomination form and attached documents, materials, etc. is true and correct to the best of my knowledge Respondent s Name: Designation: Mobile No: Email ID: Please send the completed nomination form to Startup 50 Nomination Centre: Please send the completed nomination form along with supporting literature only via email to below mentioned email ids by 30th April 2023. Email ID: Startup50@DNB.com Disclaimer: By filling up and submitting this nomination form, you hereby give your free and voluntary consent to Dun & Bradstreet for use of any and all information, data, materials, documents provided by you herein for the purpose of rendering services in relation to D&B Startup 50 and the related special report. Further you hereby give your free and voluntary consent to Dun & Bradstreet to share the aforementioned information with its sponsors, and to Dun & Bradstreet and the sponsors to contact you with information about their respective products, services, and events. Your privacy is important to Dun & Bradstreet, and you may review its privacy notice retained at https://www.dnb.co.in/privacy-policy 20

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