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About
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FAST Intake Form
Contact Information (6 Questions)
Primary Contact Name
First
Last
Email Address
Phone Number
Company Name
Job Title/Role
Job Title/Role
- None -
Founder/CEO
CTO/Technical Lead
Principal Investigator (PI)
Business Development
Research Faculty
Consultant
Other…
Enter other…
Company Profile (6 Questions)
Are you headquartered in Ohio?
Yes
No
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County
- None -
Adams
Allen
Ashland
Ashtabula
Athens
Auglaize
Belmont
Brown
Butler
Carroll
Champaign
Clark
Clermont
Clinton
Columbiana
Coshocton
Crawford
Cuyahoga
Darke
Defiance
Delaware
Erie
Fairfield
Fayette
Franklin
Fulton
Gallia
Geauga
Greene
Guernsey
Hamilton
Hancock
Hardin
Harrison
Henry
Highland
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Holmes
Huron
Jackson
Jefferson
Knox
Lake
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Licking
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Lucas
Madison
Mahoning
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Medina
Meigs
Mercer
Miami
Monroe
Montgomery
Morgan
Morrow
Muskingum
Noble
Ottawa
Paulding
Perry
Pickaway
Pike
Portage
Preble
Putnam
Richland
Ross
Sandusky
Scioto
Seneca
Shelby
Stark
Summit
Trumbull
Tuscarawas
Union
Van Wert
Vinton
Warren
Washington
Wayne
Williams
Wood
Wyandot
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State
State
- None -
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
District of Columbia
Puerto Rico
U.S. Virgin Islands
Other…
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How long has the company been in business?
Pre-Company / Idea Stage
Less than 1 Year
1–3 Years
4–10 Years
11–20 Years
More than 20 Years
Number of Employees
1 (Solo Founder)
2–5
6–10
11–20
21–50
51–100
101–250
251–500
More than 500
Industry/Technology Area
Industry/Technology Area
- None -
Aerospace & Aviation
Defense & National Security
Energy & Power Systems
Healthcare
Medical Devices
Information Technology / Software
Artificial Intelligence & Machine Learning
Cybersecurity
Agriculture & AgTech
Materials Science
Advanced Manufacturing
Robotics & Autonomous Systems
Communications & Networking
Environmental Technologies
Education Technologies
Other…
Enter other…
SBIR/STTR Readiness (7 Questions)
Current SBIR/STTR Stage
Learning About SBIR/STTR
Evaluating Fit
Preparing Proposal
Ready to Submit
Awaiting Decision
Current Awardee
Are you interested in SBIR/STTR funding?
Yes
No
Have you previously submitted an SBIR/STTR proposal?
Yes
No
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Who or what organization?
Previous Award History
None
Phase I Award
Phase II Award
Multiple Awards
Program Type of Interest
SBIR
STTR
Not Sure
Target Agency (select all that apply)
DoW
NASA
NSF
DOE
HHS (NIH)
USDA
DHS
DOT
EPA
DOC (NOAA/NIST)
ED
Expected Timeline to Apply
Within 3 Months
3–6 Months
6–12 Months
More than 12 Months
Just Exploring
Support Requested (4 Questions)
What assistance are you seeking?
SBIR/STTR Strategy
Agency Identification
Proposal Review
Proposal Development Support
Commercialization Planning
Team/Partner Identification
Technical & Business Assistance (TABA)
Technology Transfer / Licensing
Government Contracting Assistance
How did you hear about us?
How did you hear about us?
- None -
Webinar/Event
Referral
University
Federal Lab
Website
Social Media
Existing Client
Other…
Enter other…
Interested in partnering with a university or federal lab?
Yes
No
Would you like a FAST/OAI advisor to contact you?
Yes
No
Follow-up Notes (1 Question)
Is there anything else you'd like us to know? (e.g. what other organizations are you currently working with for support?)
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