Industry Project Intake Form

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Company Information

Company Name *

Contact *

First

Last

Phone *

Email *

Website / URL *

Revenue *>0>$150k>$500K$1M-$5M$5M-$10M>$10M>$50M

Number of Employees *0-22-1011-3031-100101-250>250

Industry Project

Project Title *

Suggest a title (up to 150 characters in length)

Project Scope and Objective *

Describe the problem you want to solve and initial suggestions on how to solve it. Provide as much detail as possible – do not include sensitive, confidential information.

Project Keywords *

e.g. AI/machine learning, UI/UX, formulation, process optimization, compliance, prototyping

Technical Skill Requirements Keywords *

e.g. mySQL, javascript, python, After Effects, Maya, HPLC, GC-MS, focus groups, 3D printing

Research Information

My company has worked with government grant agencies, associations or incubators *

• Yes
• No

My company owns IP or patents *

• Yes
• No

My company has worked with academia and post-secondary institutions *

• Yes
• No

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How did you hear about us? *

• An organization I belong to
• Forwarded from a colleague
• Social media
• Internet search
• Other

If Other, please list how you heard about us.

Marketing Opt-In *

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• No thanks

Name *

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