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SBIR/STTR Proposal Support
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IPart Programs
SBIR/STTR Proposal Support
Travel & Training Program
Federal Funding Resources & Links
Awardees
Solicitations
About Us
The Innovation Partners
Contact Us
News
Events
FMA Application
Step
1
of
11
9%
Instructions
The Federal Marketing Assistance (FMA) program has been developed to improve your competitive position in pursuing SBIR/STTR Phase II proposals or advanced federal R&D opportunities. This application form requests information that the IPart will use in evaluating the appropriateness and quality of your request – a decision to make an award will be based on your responses. It is vitally important that your responses be complete enough to make an informed assessment. However, please be concise and recognize that we do not ask for a detailed technical discussion of your products or company.
READ EACH QUESTION CAREFULLY
and make certain you provide the information requested. The estimated time to complete this application is approximately two hours. Please read the entire application prior to starting – this will help you in gathering materials and completing the application efficiently.
FOR QUESTIONS
– please contact the Innovation Partnership representative who provided the application to you or the IPart Director – Kelly S. Wylam kelly@benfranklin.org (717) 948-4318
Click here
for application tips for funding success from the Innovation Partnership Investment Committee.
Navigating Through This Application
This application form consists of multiple pages. You can navigate between them using the
Next
and
Previous
buttons at the bottom of each page.
You may save your application at any point by clicking
save
.
You will be given a link to return to your application form.
Do not
lose this link; it is essentially your password.
You have 30 days to return after saving your progress.
All questions marked with a "*" are required for completion.
I have reviewed the "Application Tips for Funding Success" with my sponsor.
*
Yes
No
Applicant Type
*
Please Choose
Academic Institution
C-Corp
LLC
Partnership
S-Corp
Sole Proprietorship
Trust
Other
If "Other," please describe.
Which assistance program are you applying for?
*
Please Choose
Federal Marketing Assistance
Microvoucher Review
Microgrant Review
Technical Review
Applicant Information
All questions marked with a "*" are required for completion.
Formal name of the organization or company submitting the federal proposal
*
Fed Tax ID # (FEIN) 8 digit format (##-######)
*
Organization Website (URL), if applicable
Primary Contact First Name
*
Primary Contact Last Name
*
Title
*
Phone
*
Alternate Phone
Email
*
Address
*
City
*
State
*
Please Choose
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
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
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
ZIP Code (00000-0000)
*
Look up your full ZIP Code
here
.
Please indicate if the applicant is:
Woman-Owned
Minority-Owned
Veteran-Owned
Minority Status (if applicable)
Please Choose
Asian or Pacific Islander
Black or African American
Caucasian
Hispanic or Latino
Multi-Racial (not Hispanic)
Other
If "Other," please describe
Company Information
All questions marked with a "*" are required for completion.
Primary (six digit) NAICS Code
*
Click here
to find your NAICS Code.
Please identify your firm's main business activity
*
Please Choose
AGR - Agriculture/Food Processing
AUT - Factory Automation
BIO - Biotech/Life Sciences
CHE - Chemicals
COM - Computer Hardware
DEF - Defense
EDU - Education
ENR - Energy
ENV - Environment
MAN - Manufacturing Equipment
MAT - Advanced Materials
MED - Medical
NAN - Nanotechnology
PHA - Pharmaceuticals
PHO - Photonics/Optics
SOF - Computer Software
TAM - Testing/Measurement
TEL - Telecommunications/Internet
TRN - Transporation
Other
If "Other," please specify
Please identify your firm's secondary business activity
Please Choose
AGR - Agriculture/Food Processing
AUT - Factory Automation
BIO - Biotech/Life Sciences
CHE - Chemicals
COM - Computer Hardware
DEF - Defense
EDU - Education
ENR - Energy
ENV - Environment
MAN - Manufacturing Equipment
MAT - Advanced Materials
MED - Medical
NAN - Nanotechnology
PHA - Pharmaceuticals
PHO - Photonics/Optics
SOF - Computer Software
TAM - Testing/Measurement
TEL - Telecommunications/Internet
TRN - Transporation
Other
How many patents have been issued to your company? (Please type 0 if none)
*
How many (if any) patents do you expect to be issued between now and the next 3 years? (Please type 0 if none)
*
Full-time employees based in Pennsylvania (Please type 0 if none)
*
Part-time employees based in Pennsylvania (Please type 0 if none)
*
Full-time employees worldwide (Please type 0 if none)
*
Part-time employees worldwide (Please type 0 if none)
*
Full-time PA-based manufacturing or development subcontractors (Please type 0 if none)
*
Part-time PA-based manufacturing or development subcontractors (Please type 0 if none)
*
Please select a year and provide your company's revenue for the last 3 years (excluding grants & loans).
Current Year
2016
2017
2018
2019
2020
2021
2022
2023
2024
2025
Current Year Revenue
Last Year
2016
2017
2018
2019
2020
2021
2022
2023
2024
2025
Last Year Revenue
2 Years Ago
2016
2017
2018
2019
2020
2021
2022
2023
2024
2025
2 Years Ago Revenue
Location
All questions marked with a "*" are required for completion.
County
*
Please Choose
Adams
Allegheny
Armstrong
Beaver
Bedford
Berks
Blair
Bradford
Bucks
Butler
Cambria
Cameron
Carbon
Centre
Chester
Clarion
Clearfield
Clinton
Columbia
Crawford
Cumberland
Dauphin
Delaware
Elk
Erie
Fayette
Forest
Franklin
Fulton
Greene
Huntingdon
Indiana
Jefferson
Juniata
Lackawanna
Lancaster
Lawrence
Lebanon
Lehigh
Luzerne
Lycoming
McKean
Mercer
Mifflin
Monroe
Montgomery
Montour
Northampton
Northumberland
Perry
Philadelphia
Pike
Potter
Schuylkill
Snyder
Somerset
Sullivan
Susquehanna
Tioga
Union
Venango
Warren
Washington
Wayne
Westmoreland
Wyoming
York
Congressional District Number
*
Click here
to find your Congressional District Number.
PA State House of Representatives District Number
*
Click here
to find your State House of Representatives District Number.
PA State Senate District Number
*
Click here
to find your State House of Representatives District Number.
Referred By
All questions marked with a "*" are required for completion.
What organization invited you into the Innovation Partnership MicroGrant Program?
*
Please Choose
Ben Franklin TP of Central & No. PA
Ben Franklin TP of Northeastern PA
Ben Franklin TP of Southeastern PA
Catalyst Connection
Delaware Valley IRC (DVIRC)
Innovation Works (BFTP of Southwestern PA)
Life Sciences Greenhouse of Central PA
Manufacturers Resource Center (MRC)
Manufacturing Technology IRC (MANTEC)
Northeastern PA IRC (NEPIRC)
Northwest PA IRC (NWPIRC)
PA BioTech
Penn State University
PENNTAP
Pittsburgh Life Science Greenhouse
SBDC Bucknell University
SBDC Clarion University
SBDC Duquesne University
SBDC Gannon University
SBDC Kutztown University
SBDC Lehigh University
SBDC Lock Haven University
SBDC Penn State University
SBDC Saint Francis University
SBDC Saint Vincent University
SBDC Temple University
SBDC University of Pittsburgh
SBDC University of Scranton
SBDC Wharton School
SBDC Wilkes University
The Industrial Modernization Center (IMC)]
University City Science Center
University of Pittsburgh OED
Other
If "Other," please describe
Company Overview
Please provide a brief overview of your company. This should include: years in operation, sources of technology, core competencies, target markets, products, and drivers of product development. Also include present size (annual sales and number of employees), current products/services that have significant sales, and a very brief indication of how you will grow and maintain your business.
All questions marked with a "*" are required for completion.
Company overview:
*
Previous Federal Grant Experience
Have you or your organization applied for federal grants in the past? If so, please describe:
Approximate number of proposals
What type were the majority of your previous awards?
Please Choose
SBIR
STTR
ATP
BAA
Government Contract
Please identify the Federal agencies where you have submitted applications (check all that apply):
Dept. of Commerce
DOD
Dept. of Education
Dept. of Energy
DHS
DOT
EPA
NASA
NIH
NSF
USDA
First year a proposal was submitted: (format yyyy)
Last year a proposal was submitted: (format yyyy)
Have you or your organization previously received federal grant funding? If so, please describe:
Approximate no. of awards received by the company currently making application:
Approximate no. of awards received by you under other companies:
What type were the majority of previous awards received by the company currently applying:
Please Choose
SBIR
STTR
ATP
BAA
Government Contract
Approximate total dollar amount of awards to this company:
First year an award received by this company: (format yyyy)
Last year an award received by this company: (format yyyy)
Targeted Grant Program Description
All questions marked with a "*" are required for completion.
What type of proposal are you planning?
*
Please Choose
SBIR Phase I
SBIR Phase II
STTR Phase I
STTR Phase II
Fast Track
ATP
BAA
Other
(Describe if other)
To which DOD agency are you applying?
*
Please Choose
Air Force
Army
DARPA
MDA
Navy
If applying to the NIH, please indicate which Institute:
*
Please Choose
NCI (National Cancer Institute)
NEI (National Eye Institute)
NHLBI (National Heart, Lung, and Blood Institute)
NIA (National Institute on Aging)
NIAAA (National Institute on Alcohol Abuse and Alcoholism)
NIAID (National Institute of Allergy and Infectious Diseases)
NIAMS (National Institute of Arthritis and Musculoskeletal and Skin Diseases)
NIBIB (National Institute of Biomedical Imaging and Bioengineering)
NICHD (National Institute of Child Health and Human Development)
NIDCD (National Institute on Deafness and Other Communication Disorders)
NIDCR (National Institute of Dental and Craniofacial Research)
NIDDK (National Institute of Diabetes and Digestive and Kidney Diseases)
NIDA (National Institute on Drug Abuse)
NIEHS (National Institute of Environmental Health Sciences)
NIGMS (National Institute of General Medical Sciences)
NIMH">NIMH (National Institute of Mental Health)
NINDS (National Institute of Neurological Disorders and Stroke)
NINR (National Institute of Nursing Research)
NLM (National Library of Medicine)
Proposal due date (format mm/dd/yyyy)
*
If available, please copy the URL of the web page containing the research topic description in the solicitation or program announcement. (Note: If the research topics have not yet been announced, please leave this section blank.)
URL
In its published solicitation, each federal agency lists the various research topics for which projects will be selected. In order to receive funding, you must show that your proposal is a good match with one of these topics. Please type below
an exact copy
of one or two paragraphs directly from the solicitation that you think best shows this match.
Paragraphs from solicitation:
*
Planned Proposal Information
All questions marked with a "*" are required for completion.
Title of proposal to be prepared:
*
Estimate of grant dollars to be requested from federal agency for this proposal:
*
Name of Principal Investigator for this project:
*
Please list the names of any additional key personnel who will be assisting with the project:
Name 1
Name 2
Name 3
Name 4
Name 5
If more individuals are involved, please add their names here:
Phase I Proposal title:
*
Phase I Principal Investigator first name:
*
Phase I Principal Investigator last name:
*
If this application is for assistance with an SBIR or STTR Phase II application, please provide specific information about the associated Phase I project:
Phase I Project Start Date (format MM/DD/YYYY):
MM slash DD slash YYYY
Phase I Project End Date (format MM/DD/YYYY):
MM slash DD slash YYYY
Phase I Project Title
Phase I Award Amount:
What were the technical objectives for this project?
Briefly describe the results that were obtained.
Briefly describe your interactions with the funding agency to date, explaining why you feel they will accept this application.
*
FMA Section II
FMA SECTION II TEMPLATE
Please download and complete the FMA Section II Template above. This must be completed and uploaded before submitting this online application. This section must be saved and
converted to PDF format before being updated
.
There is a limit of 11 pages for this section and a maximum PDF file size of 1MB.
Please upload your FMA Section II Template here:
*
Accepted file types: pdf, Max. file size: 1 MB.
Budget for Preparing the Proposal
Please fill out
THIS BLANK BUDGET DOCUMENT
. All relevant fields are required. Please upload it below when completed.
Please upload your budget document here:
*
Max. file size: 100 MB.
59004
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