Company Name *

Company Headquarters: State / Province *

Contact Person / Title *

Email *

Phone Number *

Website *

Category (choose one): *

Enter required value Life Sciences (Pharma, Med devices, HealthCare IT, Digital or Mobile Health, etc.) Technology, Services, & Consumer: (Hardware & Software, Social Media, Web 2.0., Fintech, AgTech, etc.)

Year Company Founded: *

Number of Employees (FTE): *

Funding Dollars Raised to date: Non-dilutive

Funding Dollars Raised to date: Equity

Lead Investor on your last round:

At your current running rate, what are your annual revenues?

Pre-Revenue $0 - $500,000 $500,000 - $1 million $1 - $3 million $3 - $5 million Over $5 million

Explain the problem your idea addresses (100 words max) *

Explain your solution and how it is exceptionally ingenious, creative, and innovative. *

Especially versus other solutions (max 300 words):

What is the Serviceable Addressable Market (SAM) inUSD? (max 50 words) *

How has this company demonstrated progress toward implementing your solution? (max 200 words): *

What is the proprietary or the source of your defensibility? *

What makes you and your team uniquely able to execute on your plan? *

Do you have any partners that you are working with? Who and why?

Targeted Exit: Discuss your exit strategy. *

Targeted Exit: Discuss your exit strategy including type of exit possible, path to exit, timing, additional investment dollars needed to reach exit, core value you provide to potential acquirers. (max 300 words)

Please provide your pitch deck: *

20MB max

Name of Nominating ACA member / group *

Please Read Description and Affirm: *

By submitting this application for consideration of the 2025 Luis Villalobos Award, I understand that the company name will be noted in the public information for the award and, should my company be named a category winner one person from the company will attend the award ceremony in Denver, CO April 16, 2025.

I Affirm