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To request assistance and/or funding from LSGPA, please complete this brief questionnaire.

1. Contact information

Company/Institution name

Primary contact

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Email

Website (if appropriate)

2. Business location

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If not located in Pennsylvania, are you considering relocation or expansion?
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To find the area LSGPA serves, please click here.

3. What category best describes your life science technology?

Brief (200 word max.) description of business/technology

4. Status of enterprise

5. Type of assistance you are interested in?

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