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• <br /> 1► <br /> ELK RIVER BUSINESS INCUBATOR <br /> APPLICATION FORM <br /> Name of Business: <br /> T 9= d --� � s+z.S (., . <br /> K � � <br /> Name of Principal: ' ) ? 3 ret - (-4)ch-i' `ate- /ete-8io`"er/CLCD <br /> Address: 000 {Sar' (mac rt,J r01.4 SS3=3 <br /> Phone: 7(42--b - Z�(:{ — /817 Fax: 1(0 3 -Z-`f/— /Cr 7-3 <br /> Ownership structure: Sole Proprietorship ❑ <br /> Partnership V4 "" <br /> Corporation ' <br /> Business is primarily involved in: Research and Development _ <br /> Product Manufacturing/Assembly <br /> Other n <br /> Principal product(s): c c t <br /> • <br /> Activities to be undertaken in the incubator facility: C42'eQQ-t4`£'— <br /> ctkj C Oodui-P,3.0 cs4 zj- t cJ <br /> Projected number of employees (including principal) at incubator <br /> operation: <br /> Full Time Part Time <br /> Initially 3 <br /> After 6 months !,o <br /> At the end of 1 Year to <br /> At the end of 3 Years 3 WA <br />