Seed Grant Program Please fill out and submit this form. Submitting this form will generate a printable version of the completed form, to be signed and returned with your application. *Indicates required field. 1. Project Title* (50 characters max) 2. Technology Sector(s) that best fit your business The selected sector boards will evaluate and rank order proposals. Check all sectors that apply on the left.  Regardless of the number of sectors you choose, please select one as preferred. Technology Sectors * Preferred * Advanced Technologies for Forestry and Agriculture Aquaculture and Marine Technology Biotechnology Information Technology Composite Materials Technology Environmental Technology Precision Manufacturing Technology 3. Type of work proposed Product Development Consulting Work Technical Assistance Market Analysis Other (please describe)   4. Principal Contact First Name * M.I. Last Name * Suffix (Jr/Sr/III) Job Title(30 characters max) Business Name * Business Address   Address Line 1 * Address Line 2 City * State *  Zip Code * County * (Select a County) Androscoggin Aroostook Cumberland Franklin Hancock Kennebec Knox Lincoln Oxford Penobscot Piscataquis Somerset Sagadahoc Waldo Washington York (None) Home Address   Address Line 1 * Address Line 2 City * State *  Zip Code * No. of Years in Business * No. of Full-Time Employees * Business Stage * Please choose To be established Pre-Revenue Established with Revenue Business Description * (150 Characters Max) 150 characters left Business Type Sole Proprietorship Limited Partnership Non Profit Corporation Other (please describe)      Filed With Secretary of State? Yes   No If no, state reason Business Phone * Home Phone * Fax Number E-mail NAICS code, if known (formerly Business Standard Industrial Code (SIC)) EIN (Employer Identification Number) Format: XX-XXXXXXX 5. Other principals involved in project 6. Award amount requested * (Numbers and commas only) 7. Matching funds amount and source(s) Amount * (Numbers and commas only) Source(s) 8. Names from which to withhold proposal information or "None": * Unless otherwise indicated, Full Proposals will be evaluated by the MTI Technology Board Members and the MTI Board of Directors. 9. How did you first learn of MTI?   MTI Proposal Preparation Workshop Web Site/MTI E-mails Radio Ad Friend/Colleague Service Provider (MEP, Maine Patent Program, etc) Newspaper Article Other Workshop (which one?) Other (please describe) 10. What type of proposal is this?   New Proposal Proposal is a resubmission Proposal is related to a previous award Please review all information for accuracy before submitting.