Application for Startup Rate

Contact Name

Title

# of years working in the space industry

Telephone

Company Name

Company Website

Primary Product(s) or Service(s)

Target Audiences/Customer Base

Major Competitors

Type of Business *

Sole proprietorship

Corporation

Partnership

Limited Liability Company

Date of Registration/Incorporation

# of employees (in space business)

Headquarters Address City/State/Zip

Country

Telephone

Total amount of funding received to date

Top three sources of funding

1.) Indiv/Company Name

Type of Funding

Amount

2.) Indiv/Company Name

Type of Funding

Amount

3.) Indiv/Company Name

Type of Funding

Amount

Gross sales of space products or systems, if any for the following years

2015 $

2016 $

1.) Name of Founder (if not applicant)

2.) Name of Co-founder (if not applicant)