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Innovation Powerhouse
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Name
*
First
Last
Email
*
Mobile
*
Country
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— Select Choice —
First Choice
Second Choice
Third Choice
Postcode
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Age Range
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18 – 25
26 – 30
31 – 35
36 – 40
41 – 50
51 – 60
61+
How would you best describe yourself?
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First-time founder
Second-time founder
Serial entrepreneur (3+ ventures)
Startup operator transitioning to founder
Other
What stage is your current business at?
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Idea stage
Early stage (pre-revenue)
Revenue generating
Scaling
Established and expanding
Exited (currently building something new)
Other
activities business most
Time working on your current venture?
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Less than 6 months
6–12 months
1–2 years
2–5 years
5+ years
What best describes your industry?
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Tech / SaaS
Service business
E-commerce
Health / Wellness
Education
Hospitality / Food
Property / Construction
Finance / Fintech
Creative / Media
Coaching / Consulting
Other (short answer)
What is business model?
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B2B
B2C
Marketplace
Subscription / SaaS
Services
Hybrid
Other
What size is your team?
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Just me
2–5
6–10
11–20
20+
Approx annual revenue
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First Choice
Second Choice
Third Choice
Top 3 biggest personal challenges as a founder?
Loneliness / lack of peer support
Decision fatigue
Leadership & hiring
Imposter syndrome
Product or market clarity
Scaling systems
Cashflow
Work–life balance
Motivation & accountability
Mental or physical wellbeing
Top 3 biggest business challenges right now?
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Marketing & customer acquisition
Sales consistency
Building the right team
Product development
Operations & systems
Funding / capital
Time management
Pricing & margins
Retention / churn
Top 3 goals for the next 12 months?
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Grow revenue
Launch new product/service
Improve systems & processes
Strengthen leadership
Build a team
Expand internationally
Improve wellbeing
Build accountability
Connect with other founders
Which activities are you most interested in?
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Monthly private founder dinners
Weekly active meetups (walks/hikes/runs)
Quarterly learning events
Accountability groups
Peer mentorship
Business roundtables
Likelihood of attending monthly dinners?
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Definitely — this is a priority
Very likely
When possible
Not sure
These dinners would be local, with like minded founders at all different stages of building their business.
Are you open to hosting or co-hosting a dinner?
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Yes
Maybe
Not at this stage
Hosting could look different each month like booking a restaurant or bring founders into your office or home.
What motivates you to join this founders’ club?
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Deep conversations with other founders
Mental & physical wellbeing
Accountability & structure
Growth & continuous learning
Meaningful local friendships
Building a strong network
Which values matter most to you?
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Honesty & vulnerability
Ambition
Generosity
Curiosity
Discipline
Integrity
Balance & wellbeing
What is your business about?
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(1–2 sentences)
Hardest part of your founder journey so far?
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(1–2 sentences)
What makes community incredibly valuable?
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In your opinion (1–2 sentences)
How did you hear about us?
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Social media
Event
Search
Referral / Other
Anything else you’d like us to know?
*
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