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* 1. Please enter your name

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* 2. Please enter your email address

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* 3. Is your company growing in staff / sales jurisdictions / property

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* 4. Are you looking to increase capital / productivity / local economy / energy efficiency or decrease pollution?

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* 5. Which province are you located in?

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* 6. What does your business do?

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* 7. How many staff do you have?

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* 8. Our business is 50%+ owned by: (Please select all that apply)

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* 9. Are you incorporated and have made over $30,000

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* 10. Do you have a specific project planned? Such as developing a new product, or enhancing an existing one? Please provide details.

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* 11. Have you received any funding before?

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