Inicio / Initial Intake Form Initial Intake Form Formulario Name * Date * Phone * E-mail * Role / Affiliation with the company * Title * Company Name * Address * City, State, Zip * Have you spoken to anyone in our office? if so, with whom? * Your role on behalf of the company * Notes * Company/Project name * Current Location * Existing in Monterrey? * Select.... Yes No Industry Description NAICS New employees projected by year Year 1 New employees projected by year 2 Year 2 New employees projected by year 3 Year 3 New employees projected by year 4 Year 4 New employees projected by year 5-10 Year 5-10 Job types 1: Professional % Job Types2 Professional Wage Job Type3 General Wage Job Types4 General % Brief Project Criteria/Scope Est. Total Private Investment $ * Secured Financing Yes No If no, please explain Inmediate Parent Company Ultimate Parent Company Briefly describe type of assistance you are seeking Select all that apply Expansion new location Expansion existing location Relocation Headquartes Start-up Company Other Primary function of this facility Geographic region of interest Projected Timeline Initial site visit expected Prelim decision date Final decision date Enviar
