MTC Office Space Application

General Information

Business Name:

Date Business Established:

DUNS Number: If you do not yet have a DUNS Number, you can request one at: http://smallbusiness.dnb.com/establish-your-business/12334338-1.html

Principal(s), Officer(s), Control Person(s), Partner(s):
Name Title Phone Number % Ownership Key Attribute(s)

Current Business Address:

Telephone: Fax:

E-mail:

Web URL:

Previous Business Address:

Form of ownership:
C-Corporation (specify state)
Sub “S” Corporation (specify state)
LLC (specify state)
Partnership
Sole proprietor

Current State of Business

Status of Business Plan:
Complete (attached)
In progress (attached)
Need help
Other (please specify)

Attach a business plan or summary with the following minimum content:

Description of your product
Competitive advantage
Competition and/or substitutes
Market potential
Distribution plan
Market trends, peculiarities and seasonal characteristics
Legal/IP (patent, copyright, trademark) needs
Financial needs
Goals and timelines
Risks/threats of failure
Budget (if available)
Current status of product/service: (e.g. working on prototype, product in final development, etc.)

Current sales volume: (dollar volume per month)

Number of Current Employees: (include principal officers)
Full Time: Part time:
Projected number of new employees during next 12 months:
Full Time: Part Time:

Type and amount of financing used to operate business to date: (check all that apply)
Private Investors
Personal Resources
Grants (Please specify type)
Other (Please indicate specifics)

Business Needs

Immediate business development needs: (check all that apply)
Business plan assistance
Legal/IP advice
Marketing plan assistance
Networking connections
Other (Please specify type)

Approximate space requirements:
Suite (1150 square feet)
Office (133 square feet)
Single-seat Cube (49 square feet)
Double-seat Cube (94 square feet)
Other (Please specify type)

Approximate date you desire to occupy space:

Special Facility Requirements: (Electrical, ventilation, floor load, parking for large vehicles etc.)

Do you plan on doing any manufacturing or assembly? (Specify)

Do you intend to use any hazardous materials? (Specify)

I understand that a deposit equal to rent for 1 month will be required by the City of Marina.

I understand that I will be responsible for paying property tax for use of the space,
        which will be billed by the County of Monterey.

__________________________________________
Signature

__________________________________________
Print Name

_______________________
Date

Mail, fax, or hand-deliver completed application to:

Marina Technology Cluster .....................................
3180 Imjin Rd., Suite 149
Marina, CA 93933

Phone (831) 582-9718
Fax (831) 582-9546

If you can scan the form to a pdf after signing it, then you can submit it by email to Adam.Davis@barichbiz.com, CC to Susan.Barich@marinatechnologyclster.org.