Test – Work with BBC Catalyst

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Thank you for your interest in our services. Please complete the following form and one of our consultants will be in touch soon to set up a call to discuss your needs, answer questions and decide on next steps. There is no charge for this call.

Contact Information

Name*

First Last

Preferred Email*

Phone*

Company/organization name:*

(if not formed put "none")

What is your title within the company?*

(i.e., President, Founder, CEO, CSO, etc.)

Mailing Address*

Street Address

City*

City

State*

ZIP / Postal Code*

ZIP Code

Catalyst Information

How did you hear about Catalyst?*

What is your goal for completing the Catalyst Assistance Program?*

Form a company

Conduct customer discovery

Bring in strategic partner

Raise private funds

Complete a proof of concept study

Establish and hit a sales goal

Launch an MVP

Submit a Phase I SBIR/STTR proposal

Submit a Phase II SBIR/STTR proposal

Other

Other:*

SBIR/STTR Assessment Information

Before you submit your Assessment Form, we strongly suggest that you watch our free webinar “ABC’s of SBIR/STTR .” Once the form is received, one of our consultants will schedule a call with you to answer your questions, determine your current status and discuss how we can best help you. There is no charge for this call. The info provided in the webinar together with your Assessment Form make for a more productive and useful call.

Eligibility Requirements

Does your company fulfill the following SBIR/STTR eligibility requirements?

Does your company have less than 500 employees?*

Yes

Is the majority of the company (>51%) owned by individuals?*

Yes

If yes, are they US Citizens/Permanent Residents?

Yes

Does the company have any institutional, corporate and/or non-US owners?*

Yes

Do you have company-controlled R&D space?*

Yes

If no, have you identified space that you will move into at the time of award?

Yes

If yes, please describe the company facilities and identify their location:

Have you identified a Principal Investigator (PI) who will be 51% employed by the company at the time of award?*

Yes

We plan to do an STTR and have identified a PI at a collaborating institution

Briefly describe the background and qualifications of the PI:*

Tell us about your SBIR/STTR Project

Please answer the following questions that relate to your SBIR/STTR project and related technology/product:

To which Federal Agency do you plan to apply first?

National Institutes of Health (NIH)

National Science Foundation (NSF)

Department of Defense (DOD)

Department of Energy (DOE)

U.S. Dept. of Agriculture (USDA)

Another Agency

Don't know yet

If you answered "another agency" above, to which agency do you plan to apply?

Briefly describe the product to be developed:*

Please check all of the following that apply to your technology?*

Patent application submitted

Patent issued

We have trade secrets or other intellectual property (IP)

N/A

What is the ownership status of your IP?*

My company owns the IP

A university or other entity owns the IP

N/A

Briefly describe the "technological innovation" to be implemented in the product?*

Who is the intended customer for your product?*

Briefly describe your commercialization strategy?*

Previous SBIR experience

Have you ever applied for SBIR/STTR before?*

Yes

Have you received any SBIR/STTR awards?*

Yes

Briefly describe any previous/current SBIR/STTR awards:

How would you describe your proposal-writing experience?*

No previous proposal-writing experience

I've helped people write proposals

I've written proposals before but not SBIR/STTRs

I've written unsuccessful SBIR/STTRs

I've written successful SBIR/STTRs

Have you attended any SBIR/STTR training? If so, please describe briefly.*

Is there anything else you would like to add?

Grants/Contracts Management Information

Do you Currently have an accounting system?*

Yes

Please list your funding information:*

Grant/Contract Type(s)

SBIR/STTR/State/MF/Other

Phase I or II

Funding Agency(ies)

NOA received (Y/N)

Status (active/expired/ pending)

Click the + sign at the end of the row above to include additional grant information.

Please describe your company:*

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