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Interested parties should fill ou this form for initial review of their compatibility with IPF purposes and resources, and with the appropriate Institute's ability to provide technology nurturing.

Please fill out and print the form, then fax or mail it to the coordinates below.

Name of Business   
Business Address   
Business Telephone   
Business Fax   
 
Name of Principal (1)   
Address   
Principal Telephone   
Principal Fax   
Principal E-mail 
 
Name of Principal (2)   
Address   
Principal Telephone   
Principal Fax   
Principal E-mail 
 
Is this an existing business? yes    no

If yes, how long has it been in operation?


Describe the business opportunity.


What is the expected involvement of NRC scientific staff in this
project?



What is the background and experience of your company with NRC technology?


Describe the business opportunity, including sources of financing, market analysis, market assessment, and growth potential of this technology.

This information is protected under the Privacy Act.

Elizabeth White
Business Development Office and IPF Manager
100 Sussex Drive, Room 1149
Ottawa, Ontario
Canada K1A 0R6

Phone: (613) 998-5537
Fax: (613) 954-5242
E-mail: Elizabeth.White@nrc-cnrc.gc.ca