First name*

Last name*

Email*

Company name*

Mobile phone number*

Street address*

Location*

Reno

Las Vegas

Rural NV

Outside NV

International

Company Type*Please SelectC CorporationS corporationLLCPartnershipSole ProprietorshipNot Formed

NAICS code*

Is the company primarily owned and controlled by US citizens or permanent residents?*

Yes

No

Number of employees*

To Which Agency Are You Applying?*

USDA

Department of Commerce

Department of Defense

Department of Energy

Department of Education

Health and Human Services

Department of Homeland Security

Department of Transportation

Environmental Protection Agency

NASA

National Science Foundation

Which specific topic or solicitation are you targeting?*

Have you applied for an SBIR or STTR grant before?*

Yes

No

Describe your technology and how it aligns with the solicitation topic.*

Are you partnering with a university or research institution?*

Yes

No

Is the technology you're using developed at a university or research institution?*

Yes

No

List key team members and their roles.*

List any team members with prior SBIR/STTR awards*

Where are the R&D activities taking place?*

USA

Not in USA

Gender Option*

Female

Male

Non-binary

Prefer Not to Answer

Ethnicity*

African American

Asian American

Caucasian

Hispanic

Native American

Prefer not to answer

Other

Enterprise Community*

Women Owned Business

Minority Owned Business

LGBTQ Owned Business

Veteran Owned Business

Disabled Veteran Owned Business

Physically Challenged Owned Business

None of these

Prefer not to answer

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