If you plan to have your own business, or you are the owner of a company, you can apply to join the NMEI incubator program by filling in the application form below. NMEI will review your application, and contact you afterwards. You can also give us your feedback.

*Business Name:
*Present Address:
*City:
*State:	AK AL AR AZ CA CO CT DE FL GA HI IA ID IL IN KS KY LA MA MD ME MI MN MO MS MT NC ND NE NH NJ NM NV NY OH OK OR PA RI SC SD TN TX UT VA VT WA WI WV WY
*Zip Code:
*Phone Number:
Fax Number:
*Email Address:
Web Site:
* Is business registered with MS Secretary of State?  Yes No
* Business license obtained?   Yes No City No: County No:
*If no, please explain:
*Principals:
Owner Partner Member Officer Name: Title: SSN: Owner Partner Member Officer Name: Title: SSN:
*Company Structure: Sole Proprietorship Partnership Limited Liability Co Corporation
*Type of Business:	Non-Manufacturing Finance Government Services Leisure/Travel Professional Management Info Systems Sales/Marketing Other   (if other)
*Manufacturing:	n/a Assembly Only Composites Electronics Finishing Metal Fabrications Other   (if other)
*Description of major product or service:
*Initial capitalization: Less than $10,000 $10,001-$25,000 $25,001-$50,000 $50,001-$100,000 > $100,000
*Source of initial capital: Seed capital Loans Owner equity Grant
* Do you have a written business plan?  Yes No
* Present number of employees (excluding owner / partner / members / officers)