Partnership Application

Company Information

Company Name*

Company Operating Name

Please provide your operating name if it is different from your legal name

Is your company incorporated?*

Do you identify with any of the following under-represented groups?

Contact Name*

First Last

Contact Title*

Company Address*

Street Address City Province Postal Code

Phone*

Company Email*

Enter Email Confirm Email

Website

Company Type*

Is your business registered in Canada?*

If so, what year was it registered?

Canadian Revenue Agency Business #*

How many employees (FTE) does your company have?*

Please enter a number greater than or equal to 1.

How many new product(s)/service(s) has your company successfully developed and sold?*

Provide a brief overview of your company and its products or services:*