Startup Village Registration

First Name

Last Name

Position

Company

Email

Company website

Number of company employees (full and part-time)

Company stage of development Select Ideation and Conception Product Validation and Market Fit Growth and Establishing

“Are you working on topics relevant to the MICCAI FAIR Workshop, e.g. AI solutions for affordable care, and would like to be eligible for the Affordable Care Award?
If you check this box, your application information may also be forwarded to the FAIR organizers to coordinate additional highlight of your startup within their workshop Select Yes No

Company Presentation
(Max 2000 characters)

Product Description and Use Case
(Max 2000 characters)

Impact
(Max 2000 characters)

What do you expect from the Startup Village?
(Max 2000 characters)

Comments
Please let us know if you have any other information or comments you would like to be considered.
For questions contact: startupvillage@miccai2021.org

Terms and conditions