EW Tenancy Application


Please complete the following information.



Company Background

Company Name
Primary Contact
Title In Company
Please provide a brief description of your business.

Primary Contact Information

Address Line 1
Address Line 2
City
State
Zip Code
Phone Number
Email
Website

Legal Structure

If your company has been formed, which type of business entity is it?
If your company has incorporated, in which state is it incorporated?
If your company has been formed, please enter the Employer Identification Number (EIN)

Startup Development Stage Questions

Has your firm competed in the Cozad New Venture Competition?
Have you participated in the Lemelson prize competition?
Have you attended Social Fuse, Invention to Venture, or other TEC/UI Entrepreneur programs?
Does your firm have a prototype or initial prototype developed?
Please list any entrepreneurs in residence (EIR) or other business mentors you have worked with, and describe how they have helped you.

Team

Team Member #1 Name
Team Member #1 Position
Team Member #1 Resume
UPLOAD

Team Member #2 Name
Team Member #2 Position
Team Member #2 Resume

Team Member #3 Name
Team Member #3 Position
Team Member #3 Resume

Team Member #4 Name
Team Member #4 Position
Team Member #4 Resume

Team Member #5 Name
Team Member #5 Position
Team Member #5 Resume

Is your company planning to recruit additional staff and/or partners?
If yes, is your company planning to hire any students?

Product/Service

List each product/service that your company has marketed or intends to market.

Market

Who are your potential customers, and what is the size of your market?
Who are your key competitors?

Space Needs

How does your company plan to use space at EnterpriseWorks?
What is your company's target date for tenancy?
How many people will work from the space and what is their anticipated work schedule?
What space requirements do you have?
What is your desired timeline for space (summer, fall semester, spring semester)?

Required Documents

Business Plan

Certification

By checking the I AGREE box below, I certify that all the information contained in this application is true and complete. I authorize the EnterpriseWorks incubator staff at the University of Illinois to verify the information contained on this application by contacting the references given. I understand that this application, when submitted, becomes the property of the EnterpriseWorks incubator and that the application will be retained by EnterpriseWorks whether or not the application is approved. I also understand that the information contained in this application will be used only to determine my eligibility to lease space in EnterpriseWorks and will be kept confidential.
I agree