Please fill out the following application for consideration as a Mason Enterprise Center Prince William client.

Date:
Company Name :
   
Name:
Address:
City:
State:
Zip Code :
   
Phone:
Email Address :
   
Why are you interested in the
Mason Enterprise Center Incubator?
How did you hear about us?
   
BUSINESS  
Describe the product or services
your business provides (or plans to provide)
   
MARKET  
Who will buy (or currently buys)
your product or service? Is this a
local, domestic or international market?
   
COMPETITION  
Why will customers buy your product or service instead of your competitors?
   
PEOPLE  
Who makes up your current
management group and what is
their relevant experience?
How many current employees do you have?
   
STATUS  
What stage is your company at? (i.e. concept only, prototype or beta, some revenue, rapid growth?)
Is your company presently under lease at
some other facility? 		Yes No
  if yes, please explain
 
   
FINANCES  
How have you funded your business to date?
Do you have funding in place for at least the
next 6 months?
Will you need to raise money before entering an incubator facility?
   
SERVICES  
Which of the following would you consider using if you became an incubator client? Mark all those that apply,
Space: Virtual Office Cubicle Private Office
Business counseling/brainstorming
Business plan/review critique
Computer network installation Ongoing Support    
Entrepreneur's education programs/seminars
Financing: loan packaging equity considerations referrals
Monitoring business progress
Networking Opportunities
Referrals/Contacts
Small Conference Rooms
Telephone service with voicemail
Telework