Partnership Application

Company Information
Company Name*
Company Operating Name

Please provide your operating name if it is different from your legal name
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?*
- Yes
- No
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:*

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Company Contributions
How many hours per week could your company dedicate to partnering on this project?*
Can your company contribute materials or supplies to the project?*
- YES
- NO
Can your company contribute cash to the project budget?*
- YES
- NO
Describe any other resources your company would be able to commit to the project e.g. use of facilities or equipment*
Describe investments, cash and time,
in this project to date:

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