FAST California Application

Thank you for your interest in applying for FAST California, CLS’s advisory program for early-stage life sciences startups. Please fill out the application form below, in its entirety, for consideration. Should you require additional assistance, please contact Shikha Sharma, ssharma@califesciences.org.

About Your Company

Company Name

Website URL

Street Address

City

State

ZIP/ Postal Code

CEO First Name

CEO Last Name

CEO Email

Title

Founding/Incorporation Date

FAST Cohort

FAST Year

Tell us more about your company. Please check all that apply:

This company is led by a woman founder or C-level executive.

Full Name

Title

Company founder, and/or senior level executive, represents Black, Latinx, Native American, or Pacific Islander population.

Full Name

Title

This company is an academic spinout.

University Name

About Your Technology

General technology areas (enter all that apply)

Describe your technology area

100 words or less

Indication area

(e.g., Oncology, Autoimmune, Neuroscience etc.)

Development stage of lead asset

Describe your stage of lead asset.

100 words or less

What differentiates you from your competitors?

(Technological advantage/ unmet need) in less than 200 words)

Proof of Concept? (POC)

(in vitro/in vivo/ toxicology etc.) in less than 300 words

FAST Eligibility

Number of Employees

Dilutive Funding Amount Raised ($)

What business and growth objectives do you wish to address through the FAST program?
(Enter all that apply; business strategy, development strategy, partnerships, non-dilutive grants, scientific expertise, collaborations, licensing, legal, IP, regulatory, clinical trial design, pitching technique, fundraising, reimbursement, etc.)

Contact Information

First Name

Last Name

Title

Phone

FAST Contact

TRUE

Upload your executive summary and bios of your executive team.

(PDF files only. For files larger than 30MB please share a Google drive link in the Comments section)

Upload your non-confidential PowerPoint deck

(For files larger than 30MB, please share a Google drive link in the "Comments" section)

Comments
Please enter any additional information you would like to share with us, including links to Google Drive documents or files >30MB

I understand that I am discouraged from submitting and/or discussing information considered proprietary during this application process and during participation in the FAST California program.

I understand that California Life Sciences, and its employees, agents, consultants, contractors, interns, volunteers shall not sign confidentiality agreements relating to the FAST program.

By submitting this application you consent to allow California Life Sciences to store and process the personal information in accordance with our privacy policy. You may opt out at any time.

Contact Information