Northeastern University Capacity Building Program Application

Thank you for your interest in the Northeastern University Capacity Building Program! Session dates are Tuesday, March 24th, Monday, March 30th, and Tuesday, April 7th. Program participants must be available to attend all three sessions.

To be considered for the program, please complete the following application. Once your application has been received and reviewed by Northeastern, you will be notified of your placement in the program. Completing this form does not guarantee acceptance into the 2015 NU Capacity Building Program; you will receive a notification of your acceptance from Northeastern once your application has been reviewed.

Applications are due February 16th. Accepted businesses will be notifed by March 3rd.

If you would like to save your application and return at another time, click 'save' on the bottom of page two to receive a link via email to access your survey.

[Please note: All information gathered in this form will be kept strictly confidential, unless otherwise required by law.]

1. Please provide us with the following contact information:

First Name *This question is required.

Last Name *This question is required.

Title *This question is required.

Company/Organization *This question is required.

Street Address *This question is required.

Apt/Suite/Office

City *This question is required.

State *This question is required.

Postal Code *This question is required.

Country

Email Address *This question is required. This question requires a valid email address.

Phone Number *This question is required. This question requires a valid number format.

Fax Number This question requires a valid number format.

Mobile Number This question requires a valid number format.

Website

2. Please provide the following demographic information.

(Note: The content of your answers to the following demographic questions will not be used to determine acceptance into the program.)

3. Please identify the legal form of your company/organization: *This question is required.

4. Please describe the legal form of your organization (identified above).

5. Please identify the general category under which your business falls: *This question is required.

6. Please describe the general category of your business (identified above). *This question is required.

7. Please describe your business' product/services. *This question is required.

8. If your firm's product/services are linked to NAICS or SIC codes, please enter them below. Visit http://www.naics.com/sic-codes-industry-drilldown/ for more information.

9. Have you participated in a capacity building program/workshop in the past? *This question is required.

If yes, what capacity building program did you complete? Please be as detailed as possible. *This question is required.

10. Have you bid on a contract with Northeastern University in the past?

If yes, have you done business with Northeastern University in the past?

If yes, when did you last do business with Northeastern? Please be as specific as possible. *This question is required.

What was the nature of the work that you did with Northeastern? Please include the size of the purchase order contract(s) and as much information about the nature of the project(s) as possible. *This question is required.

11. Are you a preferred vendor/supplier of choice for any large institutions/organizations in Boston? *This question is required.

If yes, with which institution(s)/organization(s) are you a preferred vendor/supplier? Please include the size of the purchase order contract(s) and as much information about the nature of the project(s) as possible.

If you work with multiple organizations, separate entries with a semicolon. *This question is required.

12. In the past year, have you done business (i.e. signed and executed on a contract) with at least one other large institution/organization in Boston? *This question is required.

If yes, what large institution(s)/organization(s) have you worked with in the past? What was the nature of the project(s)? Please includes the size of the purchase order for each contract.

If you have worked with multiple organizations, separate multiple entries with a semicolon. *This question is required.