CNSI Technology Incubator Application

The following application has 7 sections:

  1. Company Contact Information
  2. Organizational Structure and Affiliation
  3. Financial Status and Incubation Timing
  4. Technology
  5. Incubator Space Utilization Plan
  6. Safety / Compatibility
  7. Certification


To help expedite the evaluation process, please provide as much detail as possible. It is easiest to complete this application on a computer.

 

1. Company Contact Information

 
 
 
 
 
 
 
 
 
 
 
 

2. Organizational Structure and Affiliations

 
 

List all executive officers, board members, and corporate advisors and briefly summarize their roles

 
 

Are all company founders and employees that will be working in the incubator U.S. citizens or residents? (Citizenship is not a requirement for participation in the program)

 

Is the company based on UCSB technology or IP?

 

Is the company currently licensing or optioning UC IP?

 

Are any of the company founders, officers, or key collaborators UC faculty, students, post-docs, or alumni?

 

Do any of the company's employees hold a concurrent appointment at UCSB?

 
 

3. Financial Status and Incubation Timing

 
 

Are any of the investments in the company originating from foreign (non-US) sources?

 

Please note that application processing takes 3-4 weeks from the time all required business forms are received (including EIN, W9, and certificates of insurance).

 

*Please note that membership in the CNSI Technology Incubator will be limited to two years, extendable up to a 4-year maximum tenure in 1-year increments, pursuant to the sole discretion of the CNSI Technology Incubator advisory committee.

 

Describe the benefits of the CNSI Technology Incubator Program to your company

 
 
 

4. Technology

Companies will be listed on the CNSI Technology Incubator webpage as a way of communicating the benefit of the program to CNSI stakeholders at and outside of UCSB. Answers to these two technology questions will help determine alignment with CNSI's mission. Answers should be broadly understandable and should not contain any confidential information.

 

Provide a brief overview of the company's technology; what are you working on?

 
 

What is the company's mission statement? What problem does the technology / product solve?

 
 
 

5. Incubator Space Utilization Plan

 

At the initiation of the lease. Amendments to the lease to accommodate company growth may be possible, depending on availability of space.

 

Does the company require space to hold/host a dedicated server?

 

Will the company be using additional facilities/workspace off campus?

 

Will the company leverage any Shared Experimental Facilities at UCSB?

 
 

6. Safety / Compatibility

 
 

Does any of the work you plan on conducting as a tenant of the CNSI Technology Incubator have a defense related application or involve military inputs or outputs (International Traffic in Arms Regulations (ITAR) or Export Administration Regulations (EAR))?

 
 

7. Certification

 

By checking the box below, I hereby certify under penalty of perjury that the information provided within this application and accompanying business plan is true and complete to the best of my knowledge.

 

Name and title of individual completing application

 

Email of individual completing application