First Name *

Last Name *

Email *

Phone *

Company Name *

What NAICS industry (4-digit) code best describes your business? *
- Select Option 3251 Basic Chemicals 3252 Resins and Synthetic rubbers, Fibers, and Filaments 3253 Pesticides, Fertilizers, and other agr. Chemicals 3254 Pharmaceuticals and Medicine 3259 Other Chemical Products 3261 Plastics Products Manufacturing 3331 Agr., Construction, and Mining Machinery 3332 Industrial Machinery 3333 Commercial and Service Industry Machinery 3336 Engines, turbines, and Power trans. equipment 3339 Other General-Purpose Machinery 3341 Computers and Peripheral equipment 3342 Communications equipment 3343 Audio and Video equipment 3344 Semiconductors and other electronic Components 3345 Navigation, Measurement, and Control Instruments 3359 Other electrical equipment and Components 3361 Motor Vehicles 3362 Motor Vehicle Bodies and trailers 3363 Motor Vehicle Parts 3364 Aerospace Products and Parts 3369 Other transportation equipment 3391 Medical equipment and Supplies 5112 Software Publishers 5174 Satellite telecommunications 5182 Data Processing and hosting 5191 Other Information 5413 Architecture and engineering 5415 Computer Systems design 5417 Scientific research and development 6215 Medical and diagnostic laboratories Other

If you chose "other," what 4-digit NAICS code best describes your business? (https://www.census.gov/naics/)

Dollar value of all private sector investments raised to date *

Gross Revenue in past 12 months (exclude capital gains, sales tax collected, internal transfers, and amounts collected on behalf of another entity) *
Please enter a value greater than or equal to 0.

Number of employees over the past 12 months (add up all full-time, part-time, and temp, excluding contract workers) *
Please enter a value greater than or equal to 0.

Number of pay periods over the past 12 months *
Please enter a value greater than or equal to 0.

Will you submit semi-annual economic impact reports to the Michigan Economic Development Corporation for five years? *
- Select Option Yes, we'll report every 6 months No, we do not want Business Accelerator Funds