Company name? *

 
Website address? *

 
First name? *

 
Last name? *

 
Mobile phone number? *

Please use this format: +32 490 12 34 56
 
What is your role in the startup? *

 
Describe your startup

 
Which country is your startup based in? *


 
Which city? *

 
How many people work in your startup? *

 
Select the sector that suits your product or service the most *


 
Did you already participate in an accelerator program before? *

     
 
Which accelerator did you participate in? *

 
You can attach additional description of your product or service

 
Do you meet the main acceptance criteria? *


 
How much money did you already raise? (EUR)

If you don't feel comfortable disclosing this information, we're happy to have this discussion at a later stage.
 
What are your expectations for Orange Fab BeLux? *

What is your dream scenario? (e.g.: Try out different use cases of your product with a Telco player / Distribute your products in the retail outlets of Orange / ... )
 
Why do you want to collaborate with Orange Belgium and/or Orange Luxembourg? *

 
How did you hear about us? *

Thank you for applying to Orange Fab Belgium & Luxembourg.

Your application will be reviewed for selection as of September 2018.

If any questions, feel free to contact us by emailing hello@orangefab.be

We'll keep in touch!