[M]IC Application Form

MAGNET INCUBATION CENTER APPLICATION
All required fields marked with an asterisk.














Product/Service Description and Value*
How did you hear about us?

Who referred you (if applicable)?
What is your industry?*

Number of full-time employees:
Describe your company and/or product.
How much has been invested in your company to date?
What are the sources of your investment?

If other, please specify:
Woman Owned?   

Minority Owned?   

If so, what minority group do you associate yourself with?

Are you willing to relocate?