Welcome to the Puerto Rico 5G Zone & Blockchain Ignition Lab.  It is our goal to provide the optimal value to you based upon your needs.  Please fill out this brief application form so that can better understand your business and interests related to both our physical infrastructure and our expert networks.  This information will remain confidential and is only for internal purposes.  
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Email *
Legal Company Name *
Trade Name *
Physical Headquarters Address *
Other Location
Website
Type of Business *
Primary Industry *
Secondary Industry
Primary Product or Service *
Primary Contact Name *
Primary Contact Phone # *
Primary Contact Email *
Primary Time Zone *
Projected Lab Use *
Projected Monthly Use Frequency *
Projected Location of Use *
List of Authorized Users *
Fiscal Year End
Authorization to list membership *
Required
When we receive your payment, we will reach out to schedule a brief call to walk you through our onboarding process.  This will include a tutorial for registered users to access our lab scheduling software, lab security protocols,  rules of confidentiality, and project collaboration covenant.  
A copy of your responses will be emailed to the address you provided.
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This form was created inside of Puerto Rico 5G Zone.