All fields are required with the exception of those marked optional.
Personal Information
Owner First Name:
Owner Last Name:
Home Address:
Home City:
Home State:
Choose a State...
Outside USA
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Alberta
Arizona
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California
Colorado
Connecticut
Delaware
District Of Columbia
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Kansas
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Louisiana
Maine
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Maryland
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Montana
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New Jersey
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New York
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Ohio
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Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Home Zip:
Home Phone:
Email:
Business Information
CEO/President (if different):
Business Name:
Business Website:
Address:
City:
State:
Choose a State...
Outside USA
Alabama
Alaska
Alberta
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District Of Columbia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Manitoba
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Zip:
Phone:
Current number of employees:
Select number of employees...
under 10
11 - 25
26 - 50
51+
Additional employees to be hired if you locate In the Incubator:
Business Description:
Legal form of business
(Sole Proprietor, LLC, etc.):
Partners/ Key Investor(s):
1:
2:
2:
4:
Date business started
(or planned start-up date):
<-- Click here to pick date
Space required:
Type of space:
Equipment to be used (list):
Will you have any of the following?
Hazardous waste
Emissions
By-products
None
Special requirements, if any
(power, access, ventilation, etc.)
When are you looking for occupancy
(On or about) ?
<-- Click here to pick date
Why do you wish to locate in the Business Center?
How do you see the Business Center assisting you?
Do you plan to locate in Schenectady County after you leave the incubator?
Yes
No
Do you require assistance with your business plan?
Yes
No
Is your leasing of space in the Business Center dependent on securing financing?
Yes
No
If yes, from where?
Accountant:
Lawyer:
Are you the majority owner or operator of any other business(es)?
Yes
No
If yes, please name:
How did you hear about SCCBC?
References
2 Business References:
1:
2:
2 Credit References:
1:
2:
Submission Info
Submitted By:
Title:
Submission Date:
<-- Click here to pick date
NOTE: The Schenectady County Community Business Center is owned by the County of Schenectady and operated by The Schenectady County Community Business Center, Inc. a 501C(3) not for profit organization. Only full-time businesses are accepted as tenants. Tenants of the Business Center are required to sign a formal lease that, among other stipulations, requires a liability policy naming SCCBC and a security deposit. Regular financial reporting is required to the Executive Director. Businesses graduating from the incubator are expected to relocate within Schenectady County.
Rev. 11/05