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First name *

Last name *

Title *

Email *

Phone *

Business name *

Business website

Industry *

Business address *

City *

State *

Zip code *

Please list key partners, academic associates and/or contractors. Multiple support organizations and specific points of contact are encouraged. *

List your Unique Entity Identifier (UEI)? Please note if your UEI number is pending or if you currently have a DUNS Number. *

What stage of development is your company in? *

How will your company benefit from SBIR/STTR funding? *

Which federal agency is most applicable to your technology and why? *

Please describe your innovation/project (100 words or less). *

If you were awarded the grant for professional services, where do you see allocating these funds? *

Lab space
Incubator program(s)
Grant writing
Research & development
Office space
Manufacturing & prototyping
Other

What is your current knowledge on SBIR/STTR programs? *

Very Knowledgable (I've applied and won an award)
Knowledgeable (I've taken workshops and done some research)
Somewhat Knowledgeable (I've heard of these programs)
Not at all (this is my first time looking into the program)

Does the project address an important problem or a critical barrier to progress in the field? *

What strategies, methodologies, and analyses are in place to accomplish the project's specific aims? *

Does the application challenge and seek to shift current research or clinical practice? *

Are the concepts, approaches or methodologies, instrumentation, or interventions novel to one field of research or novel in a broad sense? Please note any potential competitors. *

What is the proposed project's commercial potential? *

Are you any of the following? *

Small Disadvantaged Business Certification Program
8(a) Business Development Program
SBA's Mentor-Protégé Program
HUBZone Empowerment Contracting Program
Service-Disabled Veteran-Owned Small Business
Veteran-Owned Small Business
Women-Owned Small Business
None of the above

Programs

ARIZONAFAST Program Application