Incubator ApplicationCompany Name*Website Primary Contact* First Last Primary Contact Title*Primary Contact Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Primary Contact Phone*Primary Contact Email* What stage of development is your idea/startup?*Pre-Concept StageConcept StagePrototype StageSaleable Products/Services StageOtherHow long have you been working on this idea?*How is your business currently set up?*Sole ProprietorshipPartnershipC - CorporationLimited Liability PartnershipLimited Liability CorporationOtherDo you have a completed business plan for this venture?*YesNoIf no, do you have a Concept Paper or Executive Summary for this venture?YesNoIf yes to either questions above, please email your document to email@example.comDescribe what makes your product or technology unique and differentiates your business. How will you gain, grow and sustain a market position?*In what capacity are you pursuing this business?*Full-timePart-timeIf yes, which areas of expertise does the management team possess?* Prior experience with the product or service being developed by the venture Technical expertise necessary to develop the product or service Small business management expertise Marketing/Sales expertise in the industry where the product or service is to be sold Prior experience in raising capital for a new venture OtherOwnership Information: Name, title, % of ownership*Number of full-time employees:*Number of part-time employees:Number of interns/volunteers:Tell us about your team members and why they're the right people to make your company a success.*Please email resumes of the core team members to firstname.lastname@example.orgDo you have a management team established for this venture?*YesNoPlease provide a brief description of your challenges or needs.*How do you envision the eCenter assisting you in accomplishing your business goals?*Do you have funds budgeted to pay for incubation program fees (rent or affiliate fees)?*YesNoHow did you hear about the eCenter?*Anything else you would like to share? This iframe contains the logic required to handle Ajax powered Gravity Forms.