Application for CAN BE Occupancy Details Published: Monday, 13 July 2020 17:07 Click here to download a PDF version of the application. Name * Name of Business Website * Phone * Fax Email * Address Partner(s)/Principal(s) Name 1 Partner(s)/Principal(s) Name 2 Partner(s)/Principal(s) Name 3 Phone Phone Phone % ownership % ownership % ownership Attorney Name Phone Accountant Name Phone Bank Name Phone SPACE REQUIREMENTS Square Footage you are interested in Desired Date of Occupancy ELECTRICITY REQUIREMENTS Volts Amps Special Lighting Needs? Other Special Needs? BUSINESS INFORMATION New Business Existing Business Year Established * Where was the business started? Number of Full-Time Employees Number of Part-Time Employees Legal Structure of Business Sole Proprietorship Partnership Corporation (C, S, or LLC) Please Describe the Business * Ideal Stage Early Stage Prototype Stage (manufactured & sold in small quantities) Developmental Stage (product maturity, sales volume & management capability) Expansion Stage (capable of standing on your own) Briefly describe your business, product, service, and associated technology * Estimated Employment (Direct/Indirect) At Time of Occupancy Full Time Part Time Indirect One Year Later Full Time Part Time Indirect Within 3-5 Years Full Time Part Time Indirect Please list the type of services/assistance your company will require: * FINANCIAL INFORMATION What are (will be) the primary sources of financing for your business? Current capitalization requirements of your business? $0-$50,000 $50,000-$100,000 $100,000-$150,000 Over $150,000 Are you willing to accept and act upon advice from a board of mentors appointed for you? Select Yes No Are you willing to have your financials and business plan reviewed by the board quarterly? Select Yes No How did you hear about us? Additional comments: I verify that this information is current, accurate, and that it may be confirmed. Signature * Date
