Apply for Assistance
Launch NY - Application for Assistance
Title *
First Name *
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Last Name *
Your answer
Company Name *
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Job Title *
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Address *
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City *
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State *
Zip *
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Phone Number *
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Mobile Phone
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County *
Email Address *
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Website
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How did you hear about us?
I was asked to apply for assistance by:
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Industry Categorization *
Provide a brief (100 words or less) summary of your company/product/idea. Please indicate what is unique: *
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How much cash has been invested in the business to-date? *
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Please indicate sources of investment(s): (check all that apply) *
Required
How much cash are you seeking at this time? *
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Are you interested in pursuing a high-growth business strategy which may involve raising money from outside sources, including venture capital and other funds? *
Including yourself, how many full-time employees work for the company? *
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