Environmental Business Cluster

ENVIRONMENTAL BUSINESS CLUSTER APPLICATION For consideration in joining the EBC, please complete the application form. (Information submitted will be held in confidence and used only for purposes of evaluation for occupancy)
Business Name:
Principal Officer(s) and Title:
Telephone:
Fax:
E-mail:
Current Business Address:
Form of Ownership:	Corporation Partnership Sole Proprietor
Nature of Business (brief description of product/service and nature of market. Submit product brochures and company literature, if available, to the email address listed at the bottom of this form.
Brief Background of Principal Officer(s):
Date Business Established:
Current Status of Business (e.g. working on prototype, product in advanced development)
Current Sales Revenue (please indicate dollar volume per month):
Number of Employees (include principal officers):
Full time
Part time
Projected Number of Employees Within 12 Months:
Type of Financing Used to Operate Business to Date:
If Other, indicate Nature
Status of Business Plan:	Business Plan Completed Business Plan in Preparation/To be Available: Business Plan Not Started
Do You Receive Funding from the California Energy Commission?	Yes No
Approximate Space Requirements (if any):
Square Feet for Office:
Other (Please Specify):
Special Facility Requirements (electrical, ventilation, floor load, etc.):
Approximate Date You Desire To Occupy Space:
Date:
After you submit the application, please include the following items via email, fax or U.S. mail : 1. Business Plan or Summary 2. Company and Product Literature 3. Management Team Biographies email to: erika@prescienceintl.com Fax to: (408) 535-2711 or mail to: Environmental Business Cluster 2 N. First St, 4th Floor San Jose, Ca 95113 Phone (408) 938-3920