Maker to Manufacturer Needs Assessment

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* 1. Background Information

Name *

Company *

Title

Address

City/Town *

State/Province *

ZIP/Postal Code *

County *

Email Address *

Phone Number *

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* 2. Website

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* 3. Number of Employees

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* 4. NAICS Code

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* 5. Annual Revenue

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* 6. What is the current state of your business? Please choose the category that most closely aligns with your current status.

Concept Phase

Start-Up Phase

Growth Mode

Pre-IPO

IPO/Public