Sign In
Please enter your Company below and provide your password.
Company
● Company is required.
Password
● Password is required.
● Password Incorrect. Please review your credentials and try again.
(In case of clarifications or missing password please contact your Stony Brook contact)
Incubator Client Information Form
Date:
Company
*
● Company is required.
Date
RadDatePicker
RadDatePicker
Open the calendar popup.
Calendar
Title and navigation
Title and navigation
<<
<
November 2024
>
<<
November 2024
S
M
T
W
T
F
S
44
27
28
29
30
31
1
2
45
3
4
5
6
7
8
9
46
10
11
12
13
14
15
16
47
17
18
19
20
21
22
23
48
24
25
26
27
28
29
30
49
1
2
3
4
5
6
7
Lease Information:
Principal on Lease (First Name):
Principal on Lease (Last Name):
Incubator Name:
Incubator Room Numbers:
Incubator Space (sq. ft.):
Current FTEs:
FTEs Anticipated in 12 Months:
Business Information:
Business Name:
Business Type:
Current Student Interns:
Current SUNY Graduate Employees:
Business Description:
Technology Description:
Income Statement:
Amount
2022 Total Revenue:
2022 Total Expenses:
2023 Total Revenue:
2023 Total Expenses:
2024 Total Revenue (Forecast):
2024 Total Expenses (Forecast):
Grants Awarded:
Amount
Source
2020 Grants:
2021 Grants:
2022 Grants:
2023 Grants:
2024 Grants:
2025 Grants:
Employee Hires
(to date)
:
Number
Positions
2020 FTEs:
2021 FTEs:
2022 FTEs:
2023 FTEs:
2024 FTEs (Forecast):
Projected Exit Date:
RadDatePicker
RadDatePicker
Open the calendar popup.
Calendar
Title and navigation
Title and navigation
<<
<
November 2024
>
<<
November 2024
S
M
T
W
T
F
S
44
27
28
29
30
31
1
2
45
3
4
5
6
7
8
9
46
10
11
12
13
14
15
16
47
17
18
19
20
21
22
23
48
24
25
26
27
28
29
30
49
1
2
3
4
5
6
7
Equity/Debt Raised:
Amount
Source
2020 Capital Raised:
2021 Capital Raised:
2022 Capital Raised:
2023 Capital Raised:
2024 Capital Raised (Forecast):
Use of University Facilities and Programs
(Please check all that apply)
:
Attended University Workshops/Events
Accessed University Labs/Equipment
Received SBDC Counseling
Worked with a CAT (Bio, Sensor, Other)
Completed SPIR Project
Collaberated with University Faculty
Hired University Students
Mentored/Collaborated with Other Tenants
Met with Incubator Advocatge
Negotiated with Licensing and Industry Relations
Top 4 Previous 12 Month Goals/Milestones Met:
1)
2)
3)
4)
Top 4 Projected 12 Month Goals/ Milestones:
1)
2)
3)
4)
Exit Strategy:
Comments: