First Name:*

Last Name:*

Company:*

Phone:*    (e.g. 123.456.7890, 123.456.7890 x123)

Mobile Phone:    (e.g. 123.456.7890, 123.456.7890 x123)

Email Address:*

Website URL:    (e.g. http://annarborusa.org)

Address:*

City:*

State:* AB AK AL AR AZ BC CA CO CT DC DE FL GA HI IA ID IL IN KS KY LA MA MB MD ME MI MN MO MS MT NB NC ND NE NF NH NJ NM NS NT NV NY OH OK ON OR PA PE QC RI SC SD SK TN TX UT VA VT WA WI WV WY YT

Zip:*

Comments

Description of the Product or Service & Problem it is Solving:
Describe the product or service to be sold by the company and the customer problem that it solves (i.e., the need). Do you know potential market size?*

Technology Platform:
Describe the underlying technology and what needs to be done to develop the intellectual property position further. Do you have IP protected i.e. a patent or options? Was a university or corporate employee involved or resources used in the creation of the technology?*

Business Model:
How will the company generate revenue? Describe your marketing and sales strategy for capturing and defending significant market share. What are your profit expectations?*

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