MIED Company Registration

Please note that you will need an executive summary, a SmartZone certificate of eligibility and a Michigan Certificate of Good Standing available to upload.

For more information on SmartZone certification, please contact your local SmartZone contact prior to filling out this form.

(* Required)
Salutation:

Contact First Name: *
Contact Last Name: *
Company: *
Title:
Phone (no spaces or dashes): *
Alternate Phone (no spaces or dashes):
Fax (no spaces or dashes):
Email: *
URL:
Laboratory Address: *
City: *
State: *

Zip Code: *
Year Established: *
Total Employees: *
How many new employees will be added in the next year? *
Are any of your founders former Pfizer employees? *
Yes
No
Quantity of Patents Issued:
Quantity of Patents Pending:
Please describe your current stage of development and use of requested equipment: *
Please attach a business executive summary. *

Please attach your SmartZone certificate of eligibility or fax a copy to 734.761.9062.

Please attach your Michigan Certificate of Good Standing or fax a copy to 734.761.9062:

MIED Links
General Information
FAQ's
Registration Form
SmartZone Contacts

Call 734 761-9317 for more information or email MIED@AnnArborUSA.org.

MIED is a collaborative program presented by: