A capital efficient, flexible model for companies pursuing healthcare innovations

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License Application Form

We invite you to apply to become a Johnson & Johnson Innovation, JLABS resident by submitting NON-CONFIDENTIAL INFORMATON ONLY.

The information you provide will only be used to contact you regarding your application to become a JLABS resident. All information you provide here will be governed by our Privacy Policy. By providing us your information and clicking on the “SUBMIT” button below, you acknowledge you have read, understand, and agree to these conditions.

Required field *
GENERAL INFORMATION
Full Company Name: *
Key Company Representative(s) and Title: *
Telephone: *
(Numbers only, no spaces)
Fax: *
E-mail: *
Website: *
(Include http://)
Current Business Address
Address1: *
Address 2:
City: *
State: *
Zip: *
COMPANY FORMATION
Date Business Established: *
Form of Ownership: *
Industry Sector: *
Nature of Business:
(brief description of research/product/service and nature of market – please attach additional explanation of current area of focus, if necessary. Please avoid aspirational, forward-looking statements) *
Current Status of Business:
(e.g. working on prototype, product in advanced development) *
FINANCIAL INFORMATION
Amount & Type of Funding to Date: *
Projected Funding Requirements / Date / Preferred Type: *
Current Sales Revenue:
(please indicate dollar volume per month if applicable) *
Projection of Sales Revenues in 12 Months: *
Projection of Sales Revenues at 24 Months: *
Monthly Burn Rate: *
Months of Operational Capital: *
WHAT IS DESIRED MOVE-IN DATE AND LOCATION?
Month,day,year: *
PERSONNEL PROJECTIONS (FTES, PTES, CONTRACTORS, CONSULTANTS, ETC)
Start: *
Projected Number of People Within 12 Months: *
Projected Number of People Within 24 Months: *
TYPE OF ACTIVITY & SPACE REQUIREMENTS
Wet Lab Square Feet: *
Dry Lab Square Feet: *
Office Square Feet: *
Other Requirements: *
 
 
 
 
 
 
 
How did you hear about JLABS?: *