NM FAST SBIR/STTR Intake Form
Small-Business Innovation Research (SBIR) and Small-business Technology Transfer Research (STTR) Programs Intake Interview Form
Contact Person
How did you hear about the NM FAST program?
Your answer
First Name:
Your answer
Last Name:
Your answer
Email:
Your answer
Phone:
Your answer
Your Title or Role in the Business:
Your answer
Business Name:
Your answer
Business Street Address Line 1:
Your answer
Business Street Address Line 2:
Your answer
Business City:
Your answer
Business State:
Your answer
Business Zip Code:
Your answer
Business Eligibility
Is business organized as a for-profit business in the U.S.?
Does your business have less than 500 employees?
Is your business at least 51% owned by individuals?
Are those individual owners U.S. citizens or permanent residents?
Principal Investigator (PI)
The PI must be primarily employed (>20 hours/week) by the business over the full duration of the SBIR award period.
Have you identified someone in your business that can serve as PI?
Principal Investigator Name:
Your answer
Briefly describe PI qualifications.
Your answer
Small-business Technology Transfer (Optional)
The five largest agencies, DoD, HHS(NIH), DOE, NSR, and NASA, offer a companion program, called Small-business Technology Transfer Research (STTR). The STTR program requires that 30% - 60% of the research be performed by a research institute (RI), such as a university or national laboratory.
For the purposes of an STTR funding only, have you identified a Co-PI from a research institution (RI)?
If yes, Co-PI name:
Your answer
If Yes, briefly describe Co-PI qualifications.
Your answer
Project Description and Technology Innovation
Please include no proprietary information in your responses below.

SBIR/STTR funding is intended for technology innovations with commercial potential that are at the phase of proving feasibility and/or building a small-scale prototype.

What is the product or service that your business wants to commercialize?
Your answer
What technology innovation is the basis for that product or service?
Your answer
Do you have legal rights (through licensing) or protection (through patenting) on this technology?
Who are the intended customers for your product or service?
Your answer
At what stage in development would you describe your technology innovation?
Your answer
Business Laboratory Facilities
The SBIR program requires 67% - 100% of the research and technology development be performed by the small business. The STTR program requires 40% - 70% of it to be done by the small business.
Does the small business own, or have access to, research and development space?
Team
In addition to the PI and, in the case of STTR, the Co-PI, the qualifications of the entire project team are an important factor in demonstrating sufficient expertise for SBIR/STTR funding. Some of those team members can be employees (full- or part-time) of the small business, some can be contractors, some can come from a research institution (RI), and some can come from another business (small or large).

The PI and, in the case of STTR funding, the Co-PI have already been identified. Please identify up to three other key team members on this project.

If you, the contact person, are NOT serving as the PI or Co-PI, please list yourself as the 1st teammate and give your qualifications.

1st Teammate Name:
Your answer
1st Teammate Affiliation:
Briefly describe 1st Teammate Qualifications:
Your answer
2nd Teammate Name:
Your answer
2nd Teammate Affiliation:
Briefly describe 2nd Teammate Qualifications:
Your answer
3rd Teammate Name:
Your answer
3rd Teammate Affiliation:
Briefly describe 3rd Teammate Qualifications:
Your answer
Additional Services for Underrepresented Businesses
Some additional services may be available for women - or minority - owned small businesses, or businesses which reside in a Historically Underutilized Business (HUB) zone.
Is your business at least 51% owned by women?
Is your business at least 51% owned by minorities?
Is your business at least 51% owned by historically socially or economically disadvantaged individuals?
(Additional criteria can be found at https://goo.gl/CZJuHF)
Is your business at least 51% owned by a Service Disabled Veteran?
Does your business reside in a HUB zone?
(You can put your business address at http://map.sba.gov/hubzone/maps/ to verify.)
Do you have experience writing proposals for government grants or contracts?
If you have direct experience with Proposals and the SBIR/STTR Program, please provide a brief description
Have you attended any training on the SBIR/STTR programs?
Have you received an SBIR/STTR within the last two years?
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