#1) Who will be participating? Company/Organization/Individual(s)

       Name: ____________________________________________________________

       Title: _____________________________________________________________

       Telephone: ______________________  E-mail: ___________________________

#2) What do they want to accomplish with an incubator? _________________________

______________________________________________________________________

#3) What will they commit to in assisting in the incubator formation? ________________

______________________________________________________________________

#4) What will they commit to in assisting with the incubator operation? ______________

 ______________________________________________________________________

 #5) Physical facility obtained: No ___ Yes ___ (describe): ________________________

______________________________________________________________________

#6) Population within 25 miles: ____(k)  Within 15 miles: ____(k) Within 5 miles: ____(k)

 #7) Budget at this time: $ ___ (k)   Within 3 months: $___(k)   Within 6 months: $___(k)

 #8) Local industries: ______________________________________________________

 #9) Task force organized: No ___ Yes ___ (describe): ___________________________

 ______________________________________________________________________

 10) Nearest incubator/accelerator: __________________________________________

For the first key step in starting a business incubator, click here.

Helpful links:

www.servicesca.org/entrepreneurial_business_center.htm
www.servicesca.org/notact.htm
www.servicesca.org/incubator_self-sufficiency_group.htm
www.servicesca.org/incubator_startup_notes.htm
www.servicesca.org/C_Dean_Kring_bio.htm   

© Services Cooperative Association.  
All rights reserved.