Rental Application

Rental Application

Sayre Incubator Inc., T/d/b/aThe Enterprise Center 703 S. Elmer Ave., Sayre, PA 18840
Company Name
Type of Company (Corporation, Partnership, etc.)
Name of Designated Company Representative*

First NameLast Name
Title
Title
Phone Number*

Area CodePhone Number
Email*
example@example.com
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Social Security Number or EIN*
No dashes
Current Number of Employees
Project Number of Employees in Two Years
Type of space and Square Footage Required
Target Date for Locating in The Enterprise Center

MonthDayYear
Identify and briefly describe technology thrust and/or innovative products or methods your company is engaged in:
Please list The Enterprise Center Support Services your company will require:
Reason for the move (if Applicable):
Hours of Operation:
Additional Comments:
Optional:

For information gathering purposes only. This is a Equal Opportunity Program. Discrimination is prohibited by Federal Law. Complaints of discrimination may be filed with the Secretary of Agriculture, Washington D.C.20250
Principals Race:
Principals Ethnicity:
Disabled Individual:
Female Head of Household:
Please attach Business Plan, Annual Report, Brochures or any pertinent information. If you need help in completing this application or any of the required attachments, you may contact The Enterprise Center's Executive Director, Tim Phinney: 570-882-9324 for assistance.

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Signature*

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Rental Application

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