Program Form - Life Sciences Nova Scotia

Thank you for your interest in Life Sciences Nova Scotia’s Member Programs. Please select the Member program you are interested in and complete the form to submit your program funding request.

We appreciate your participation in our programs and your commitment to advancing life sciences in Nova Scotia.

Program(Required)

BioPartnering

Life Sciences Nova Scotia Member Company Name(Required)

Company Contact Name(Required)

Contact Title(Required)

Email(Required)

Phone(Required)

Address(Required)

Street Address Address Line 2 City Province Postal Code

Name, Date & Location of International Event(Required)

Rationale / Potential Outcomes Expected(Required)

Date

Technical Assitance Program (TAP)

Life Sciences Nova Scotia Member Company Name(Required)

Company Contact Name(Required)

Contact Title(Required)

Email(Required)

Phone(Required)

Address

Street Address Address Line 2 City Province Postal Code

Project Title(Required)

Project Tier(Required)

Technical Problem to be Addressed(Required)

Outline - How Will Resolution of This Problem Benefit / Impact Commercialization?(Required)

Description of Expertise Required(Required)

Identified Consultant(Required)

Date(Required)

Sales & Marketing - Photography Portfolio

Life Sciences Nova Scotia Member Company Name(Required)

Company Contact Name(Required)

Contact Title(Required)

Email(Required)

Phone(Required)

Address(Required)

Street Address Address Line 2 City Province Postal Code

Name of Photographer / Company(Required)

Date(Required)

Sales & Marketing - Video Development

Life Sciences Nova Scotia Member Company Name(Required)

Company Contact Name(Required)

Contact Title(Required)

Email(Required)

Phone(Required)

Address(Required)

Street Address Address Line 2 City Province Postal Code

Name of Video Production Company(Required)

Date

Sales & Marketing - Website Development

Life Sciences Nova Scotia Member Company Name(Required)

Company Contact Name(Required)

Contact Title(Required)

Email(Required)

Phone(Required)

Address(Required)

Street Address Address Line 2 City Province Postal Code

Name of Design Company / Consultant(Required)

Date(Required)