Howard County Health Innovation, Venture and Entrepreneurship Program (HoCo HIVE) - Participation Application

Company Information

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1. Primary Contact Name (Required.)

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2. Title (Required.)

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3. Email (Required.)

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4. Phone (Required.)

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5. Company Name (Required.)

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6. Website (Required.)

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7. Company Address (Required.)

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8. If your company is not currently located in Howard County, please indicate whether you are interested in establishing a presence in Howard County (Required.)

Yes

Maybe

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9. Year Founded (Required.)

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10. Number of Employees (Required.)

1-5

6-20

21-50

51+

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11. Company Stage (Required.)

Startup - Early-stage company building and testing a new product or business model.

Growth-stage - Company with traction that is scaling customers, revenue, and operations.

Mature company - Established company with stable operations and consistent revenue.

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12. Maryland Innovation Center (MIC) Affiliation (Required.)

Current member

Former member

Interested in learning more

Not affiliated

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17% of survey complete.

Howard County Health Innovation, Venture and Entrepreneurship Program (HoCo HIVE) - Participation Application

Question Title

* 1. Primary Contact Name (Required.)

Question Title

* 2. Title (Required.)

Question Title

* 3. Email (Required.)

Question Title

* 4. Phone (Required.)

Question Title

* 5. Company Name (Required.)

Question Title

* 6. Website (Required.)

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* 7. Company Address (Required.)

Question Title

* 8. If your company is not currently located in Howard County, please indicate whether you are interested in establishing a presence in Howard County (Required.)

Question Title

* 9. Year Founded (Required.)

Question Title

* 10. Number of Employees (Required.)

Question Title

* 11. Company Stage (Required.)

Question Title

* 12. Maryland Innovation Center (MIC) Affiliation (Required.)

1. Primary Contact Name (Required.)

2. Title (Required.)

3. Email (Required.)

4. Phone (Required.)

5. Company Name (Required.)

6. Website (Required.)

7. Company Address (Required.)

8. If your company is not currently located in Howard County, please indicate whether you are interested in establishing a presence in Howard County (Required.)

9. Year Founded (Required.)

10. Number of Employees (Required.)

11. Company Stage (Required.)

12. Maryland Innovation Center (MIC) Affiliation (Required.)