Company Profile

  • General Company Information

  • Date Format: MM slash DD slash YYYY
  • Company Financial Information

  • Date Format: MM slash DD slash YYYY
  • Company Ownership/Management

  • To better understand the companies we work with and to further our goal of diversity in our business endeavors, we are also requesting the following information about company owners. This question is optional.
  • Please provide the following information about your senior management team:
  • Job Information

  • ANY FALSE STATEMENT MADE HEREIN IS PUNISHABLE AS A CLASS A MISDEMEANOR UNDER SECTION 53a-157b OF THE CONNECTICUT GENERAL STATUTES.
  • I hereby certify that, to the best of my knowledge, the preceding information is true and complete. I further certify that I will report, in writing to Connecticut Innovations, Incorporated, any changes to the information contained herein.
  • Date Format: MM slash DD slash YYYY
  • NO FEE OR COMMISSION SHOULD BE PAID TO ANY THIRD PARTY FOR CI FUNDING. NO THIRD PARTY CAN INFLUENCE OR INCREASE THE BENEFITS AVAILABLE UNDER CI FUNDING. CONNECTICUT INNOVATIONS WORKS EXCLUSIVELY WITH ELIGIBLE COMPANIES; NOT WITH THIRD PARTIES.