Please complete the application and submit a copy with each of your two (2) business plans and an application fee of $25 (application fee waived for CED members). For information on the last year's conference schedule, application deadlines, and application fees, visit the Venture '98 conference page or call CED at 919.549.7500.

General Information

Company	____________________________________________________________

Primary Company Contact	____________________________________________	

Mailing Address	____________________________________________________

City	____________________________________________________________

State	__________________________ Zip _____________________________

Phone	__________________________ Fax _____________________________

E-mail  __________________________ URL _____________________________

Company Officers/Titles ____________________________________________

____________________________________________________________________

Number of Employees _________________ Year Founded _________________

Projected 1999 Revenues _________________

Actual 1998 Revenues ____________________   1997 ___________________

Amount of funding sought ___________________________________________

Please compose a brief, descriptive paragraph about your company's
product or service.

____________________________________________________________________

____________________________________________________________________

____________________________________________________________________

____________________________________________________________________

____________________________________________________________________

What makes your product/service unique?					

____________________________________________________________________

____________________________________________________________________

____________________________________________________________________

Please list your professional advisors:

Attorney ___________________________________________________________

Firm ___________________________    Phone __________________________				

Accountant _________________________________________________________

Firm ___________________________    Phone __________________________

Financiers _________________________________________________________

Firm ___________________________    Phone __________________________

Other ______________________________________________________________

Firm ___________________________    Phone __________________________

How did you learn about VENTURE '99?________________________________

____________________________________________________________________

____________________________________________________________________

Has your company ever participated in a similar conference? ________		
					
If so, when and where?______________________________________________

____________________________________________________________________

Who are your current investors? ____________________________________

____________________________________________________________________
		
Amount of current funding $ ________________________________________

Important Information

• All application information and business plans submitted by the applicant will be kept confidential and will be reviewed only by the CED staff and Venture '99 Selection Committee. However, CED reserves the right to publish the name and city of companies selected to present and to make a descriptive paragraph available to investors and media representatives.

• All presenters must participate in two rehearsals, one 2-3 weeks prior to the conference and an on-site dress rehearsal by April 20. Special arrangements will be made for presenters outside the Triangle area where necessary.

• Presenters will be asked to provide a 3-page company profile several weeks prior to the conference. This profile, which follows a standard format, will be included in the conference books that are provided to investors and others who attend the conference.

• In order to help us track results of the conference, presenters agree to provide CED with information about fundings for two years following the conference via an annual survey distributed by CED. This information will be for CED's internal use only and will be kept strictly confidential!

• The $25 application fee (not required of CED members) covers the cost of processing and returning your application and is not refundable. This fee must be included with your application and business plan.

• Presenters who are CED members will be assessed a $100 presentation fee which helps defray CED's direct expenses (i.e. scheduled meals and refreshments, conference material, etc.). Full participation for up to four company representatives is covered by this fee. Presenters who are not members of CED will be assessed a $200 presentation fee which will include a one-year membership.

SIGNATURE OF COMPANY REPRESENTATIVE ______________________________	

DATE _______________________

PRINTED NAME OF COMPANY REPRESENTATIVE ___________________________

Please make two (2) copies of this application and attach to each copy of your business plan, along with any other pertinent materials you believe will be useful in evaluating your application and your $25 application fee. If your plan is not selected, it will be returned via third-class mail as soon as the evaluation is completed. If your application is accepted, your materials will be returned immediately after the conference. Product samples will not be returned. It is recommended that any firm interested in participating in the conference obtain professional advice regarding applicable securities laws.

Please mail your $25 application fee (non-CED members) and 2 copies each of your application and business plan to:

VENTURE '99 Selection Committee
Council for Entrepreneurial Development
P.O. Box 13353
Research Triangle Park, NC 27709-3353