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Current Companies
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Criteria and Application
San Jose BioCenter Application
For consideration in joining the San Jose BioCenter, please complete the application form.
 (Information submitted will be held in confidence and used only for purposes of evaluation for occupancy)


General Information:
   
*Business Name:
   
*Principal Officer(s) and Title:
   
*Telephone:
   
Fax:
   
*E-mail:
   
Current Business Address:  
     Address 1:
     Address 2:
     City:
     State:
     Zip:



Company Formation:
   
Date Business Established:
   
Form of Ownership:
   
Industry Sector:
(hold "Ctrl" for multiple answers)

If Other, indicate Sector:
   
Nature of Business:
(brief description of product/service and nature
of market)
   
Current Status of Business:
(e.g. working on prototype, product in advanced development)
   
   
Current Sales Revenue:
(please indicate dollar volume per month if applicable)



Financial Information:
   
Amount of Funding to Date:
   
Type of Financing Used to Operate Business to Date:
(hold "Ctrl" for multiple answers)



Number of Employees (include principal officers):
   
Full time:
   
Part time:
   
Projected Number of Employees Within 12 Months:



Type of Application & Space Requirements (if any):
   
Client Type:
   
Wet Lab Square Feet:
   
Dry Lab Square Feet:
   
Office Square Feet:
   
Other Requirements
   
Approximate Date You Desire To Occupy Space:
   



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