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• ELK RIVER ECONOMIC DEVELOPMENT <br /> TECHNICAL ASSISTANCE PROGRAM <br /> APPLICATION FORM <br /> Name of Business: <br /> Name of Principal: <br /> Address: Phone: <br /> Fax: E-mail: <br /> Business is primarily involved in: Research and Development ❑ <br /> Product Manufacturing/Assembly ❑ <br /> Other ❑ <br /> Principal product(s): <br /> Number of Years in Operation: <br /> Current Number of Employees: <br /> IIIMost Recent Annual Sales: <br /> Technical Assistance & Operations Consulting Program Service Requested (see <br /> attached Minnesota Technology, Inc. list of services): <br /> Objective: <br /> Commitment for Growth in Elk River <br /> Expected Jobs Created and/or Retained: <br /> Expected Equipment Purchase: <br /> New Construction/Remodel/or Expansion Time Frame: <br /> Other: <br /> Signature: <br /> Printed name: <br /> • Company name: <br /> Date: <br />