Applicant Profile

Name of applicant CPR / Passport no. Position in company Contact number E-mail address

Eligibility Checklist

Business Status

• Idea of establishing a company
• Company under formation
• Start-up business (Not yet in production)
• Anticipated starting date:
• New business (Already in 1st year of production)
• Date started:
• Existing business (More than 1 year old)
• Date started:

Will your business be a full-time operation in the incubator?

• Yes
• No

How many employees do you have now?

• Full-time employees:
• Part-time employees:

Projected number of employees in the next 2 years:

Company Profile

Company name Company CR Date of registration Physical address (if any) Website address / email Current number of employees

Product / Service Information

Select the category your product/technology/service falls into:

• Smart Industries (e.g. internet of things, cyber security, big data and analytics)
• Green Economy (e.g. energy, water and waste)
• Bio Economy (e.g. health (biopharmaceuticals, medical devices and diagnostics, cosmeceuticals, cosmetics) and agricultural sectors (Agri/food processing, bioprocessing, smart agriculture)
• Other (e.g. technology offering)

What product/technology/service does your company offer? (Please specify & describe)

• Handicraft products
• Textile products
• Agriculture products
• IT products / services
• Services
• Others

Mark if your product/technology/service has any of the following features:

• Considerable expertise required for project conceptualization and execution
• Cooperation with university and other knowledge centers
• Innovation of procedures which differentiate the product/technology/service from similar ones
• Expected high value of product/technology/service
• The need to protect the product/technology

If you are already in business, has your product proven viable/successful?

Business Evaluation

Do you face any problems with your business? (Specify)

• Financial problems
• Purchase of materials
• Marketing problems
• Any other

Why do you wish to operate in the business incubator? Did you conduct any prior art searches to establish if your technology/product/service is new?

• Yes
• No

Expected Support from BSTD Business Incubator

Please choose the support you expect from the BSTD business incubator:

• Assistance in meetings with consultants and potential customers
• Assistance in establishing a company
• Legal Assistance
• Reception Services
• Advise on sales and marketing
• Assistance in internationalization
• Linkage with research centers
• Courses for new entrepreneurs
• Training in specific topics
• Specialized services of information technology

Workspace Requirements

space requirements: Please Choose an Option Fixed Workstation with Address Dynamic Workstation with Address Access with Address Fixed Workstation without Address Dynamic Workstation without Address BSTD Membership Contract Duration Expected Start Date Monthly Budget Payment Schedule Monthly Quarterly Yearly Special requirements:

• Special or high use electrical power requirements attributable to equipment used in your business
• Equipment generating noise that will require soundproofing or special partitioning
• Use of conference room
• Use of other common devices (specify):

Please provide any additional information you feel is relevant:

Declaration

IMPORTANT – PLEASE READ THE FOLLOWING CAREFULLY:

Incomplete, inadequate or inaccurate filling of the form may cause the applicant’s elimination from consideration. It is an offence to give information or to conceal any relevant information on this form and business plan. This may lead to an application being rejected.

I declare that all information supplied above in the business proposal is true and accurate and that I have not willfully suppressed any material fact. I further understand that this application is subject to review and in no way guarantees my admittance to the business incubator.

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