New Mexico Community Capital Online Application Form
General Information
* indicates a required field.
Company Name: *
Address 1: *
Address 2:
City: *
State: *
Zip: *
Primary Contact: *
Phone Number: *
E-mail Address: *
Website:
How did you hear about NMCC?
Please Choose
Accountant
Attorney
Banker
Economic Developer
Internet Search
NMCC Presentation/Outreach
Venture Capitalist
Other (please specify below):
Company Details
Corporate Structure:*
Please Choose
C Corp
S Corp
LLC
LP
Sole Proprietorship
Industry:*
Please Choose
Aerospace
Agriculture
Apparel
Biotechnology
Business Products & Services
Chemicals
Cleantech
Communications
Consumer Products & Services
Electronics/Instrumentation
Energy
Food & Beverage
Healthcare Services
Information Technology
Life Sciences
Manufacturing
Media & Entertainment
Medical Devices & Equipment
Mining/Extraction
Optics
Retailing/Distribution
Safety/Security Shipping
Software
Technology
Other (please specify below):
Number of employees:*
Year established:*
Annual Revenue ($):*
Monthly Burn Rate ($):*
Investment Amount Sought ($):*
Use of Funds:*
Current Ownership (%):*
One Sentence Pitch:*
Business Summary:*
Management:*
Customer Pain Addressed:*
Description of Product/Service:*
Target Market:*
Existing Customers:*
Sales/Marketing Strategy:*
Business Model (how does Company make money?):*
Competitors:*
Competitive Advantage:*
