Intakeformulier

With the form below you can submit an application for financing. We will review your application, discuss it internally and get back to you with a follow-up within 14 days.

Please note that in order to process your application, we require you to send us a pitch deck of your proposition. After completing the below form, you will receive an email with further instructions on how to do this. In order to verify that your pitch deck meets our requirements, please take a look at our pitch deck guidelines here.

If you have any questions, please send your question to contact@uniiq.nl.

Name*

First name Last name

What is the name of your company

What is the website

Is your proposition incorporated in a Dutch legal entity that is registered to the Chamber of Commerce (KvK)?*

Yes
No

Please be aware that we require your proposition to be incorporated in a Dutch legal entity that is registered to the Chamber of Commerce (KvK) before any UNIIQ investment procedure can be finalized.

What is the Chamber of Commerce number of your company?

Are most of your business operations located in the Dutch province of Zuid-Holland (also known as the greater Rotterdam - The Hague area)?*

Yes
No but we are relocating to this region
No

Where is your company located?

As being part of the Regional Economic Development Agency (ROM) InnovationQuarter for the province of Zuid-Holland, UNIIQ can only invest in companies within this province. If your main business operations take place in a different Dutch region, please find your local ROM at ROM-Nederland.nl

Please explain why you want to relocate your business operations to Zuid-Holland and what your time-frame is for the relocation

max 150 tekens

Your product

In which industry do you operate*

UNIIQ only invests in technologically innovative and scalable companies. Please describe your value proposition within the limit of 150 characters*

UNIIQ invests in companies that create (social and/or environmental) impact in the region. Please specify the regional added value (e.g. FTE, local partnerships) of your company within the limit of 150 characters.*

What is the Technology Readiness Level (TRL) of your company?*

Please note that UNIIQ is an early-stage investment fund, focusing on start-ups that are currently in the proof of concept stage (TLR 3-5). If you have not yet reached TRL 3, please reach out to our UNIIQ Info email address if you would like advice on how to collect funding in order to bring your proposition into the scope of UNIIQ. If you have surpassed TRL 5 with your start-up, we kindly invite you take a look at our sister-fund IQCapital which has a focus on start-ups and scale-ups which are operating at TRL 6-9.

How much funding (in EUR) are you looking to raise within the coming 12 months?*

Currently, UNIIQ can only provide ticket sizes up to 350k. UNIIQ does on some occasions perform co-financing activities. However, due to our favorable loan conditions, we do require co-investors to partake in the investment under identical conditions to the UNIIQ convertible loan agreement.

What is your timeline to raise funding?*

(weeks/months)

Have you previously been in contact with one of our colleagues at InnovationQuarter or UNIIQ?*

Yes
No

With whom have you had contact before?*

Contact details

E-mail address*

Phone number*

Your LinkedIn URL

Submit for a UNIIQ investment

Your product

Contact details