<p> Application for KUBIC Participation </p><p>Complete and return this application to [Sujata Dhakal] at <[email protected]></p><p>Company Background</p><p>Company/Project Name: Primary Contact: Er. / Mr. / Ms. Other Member Name</p><p>Please provide a brief description of your business/idea:</p><p>Primary Contact Information</p><p>Address</p><p>Phone: Email:</p><p>Team (including yourself)</p><p>Member #1: Er./Mr./Ms. Position: Member #2: Er./Mr./Ms. Position:</p><p>Member #3: Er./Mr./Ms. Position:</p><p>Member #4: Er./Mr./Ms. Position:</p><p>Member #5: Er./Mr./Ms. Position:</p><p>Kathmandu University Business Incubation Center (KUBIC) – Kathmandu University, Dhulikhel, Kavre Page | 1 Product/Service</p><p>List each product/service that your company intends to market: List and Specify</p><p>Market Who are your potential customers, and what is the size of your market?</p><p>Who are your key competitors?</p><p>Intellectual Property Does your project/idea is patentable? Do you have intention for patent registration? List any other safety/health hazards:</p><p>Access to Lab / Equipment Needed (KUBIC provide approval of any lab / equipment / processing facility within University, and also help connect to appropriate agency / institution within the network of KUBIC) List the types of equipment/machines that your company expects to use:</p><p>KUBIC Shared Office Space Use</p><p>Are you applying for virtual/ residential candidate? If residential, how many people will work at KUBIC space?</p><p>Kathmandu University Business Incubation Center (KUBIC) – Kathmandu University, Dhulikhel, Kavre Page | 2 What aspects of your Business/Project/ Idea require assistance from KUBIC? Office space </p><p>Computer (Not more than One for one group)</p><p>Printer/ Communication facilities</p><p>Internet facility</p><p>R&D facilities (access to Laboratory, Library and research center)</p><p>Business plan assistance</p><p>Administrative and secretarial service supports</p><p>Business registration support</p><p>Mentoring, Advising</p><p>Legal services support</p><p>Branding/Labeling/Designing</p><p>Entrepreneurship/ Skill development trainings</p><p>Observational industrial tours</p><p>Marketing support</p><p>Business networking support</p><p>Networking Investor/Financing Strategy</p><p>Recommendation</p><p>Financial Details: Please provide your estimation and intended support from KUBIC</p><p>Kathmandu University Business Incubation Center (KUBIC) – Kathmandu University, Dhulikhel, Kavre Page | 3 Certification My signature below certifies that all the information contained in this application is true and complete. I also understand that the information contained in this application will be used only to determine my eligibility to lease space in KUBIC and will be kept confidential.</p><p>Applicant Signature Title Date</p><p>Kathmandu University Business Incubation Center (KUBIC) – Kathmandu University, Dhulikhel, Kavre Page | 4</p>