Full Name:
Business Name:
Phone#:
Date:
City: State: Zip:
1. What type of business do you have?
Service Light Mfg Retail High
Other Type
2. Describe your target market and is there an International market ?
3. How many years have you been in business?
Less than 1 year Less than 5 years More than 5 years
4. Have you obtained a business license?
Yes No
5. Is your business a:
Sole Proprietorship Partner Corporation
6. What is your annual gross revenue?
$5,000 - $25,000 $25,001 - $50,000 $50,000 or above
7. Where is your business presently located and how are you currently operating?
8. Approximately how much space would you need (space square footage)?
9. Why do you want to move your business to the Incubator?
10. Do you have a business plan? Yes No
