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Entrepreneur/Business Venture Registration Form

Please fill out the following form to assist us in identifying the eIncubator/start-up services that meet your needs. While all information is optional, we recommend that you fill out the form as completely as possible. This will aid us in matching specific services to your needs. If you would like to know more about our process before proceeding, please review our Entrepreneur FAQ.

Contact Information:

Contact Person:
Business Name:
Website Address:
Address 1:
Address 2:
Province / State:
Postal Code / Zip Code:
Telephone Number:
Fax Number:
E-Mail Address:
How did you hear about
Who referred you to

Please provide the following information on your venture:

Elevator Pitch:
Business Description:
(500 words or less)
Do you have a
business plan?

What kind of eIncubation/start-up services are you interested in (check all that apply):

Funding Technology Infrastructure
Office Space Management Team/HR
Marketing/Sales Product Development
Business Development Business/Strategic Planning
Legal Accounting

Additional comments: