ExporTech™ Scholarship Application

Please fill out the below form to participate in ExporTech™ and potentially become eligible for a scholarship from the Wisconsin Economic Development Corporation. If you have questions, please contact Roxanne Baumann, Director Global Engagement, WMEP at 262.442.8279 or [email protected]

Company Name(Required)

Address(Required)

Street Address City ZIP / Postal Code

Main Company Phone(Required)

Company Website(Required)

First Participant Information

Name(Required)

First Last

Title(Required)

Email(Required)

Direct Phone(Required)

Second Participant Information

Name

First Last

Title

Direct Phone

Third Participant Information

Name

First Last

Title

Direct Phone

Fourth Participant Information

Name

First Last

Title

Direct Phone

Company Background

County

Minority-Owned

Yes

Women-Owned

Yes

Tribally-Owned

Yes

Total Number of Employees(Required)

Total Number of Employees in Wisconsin(Required)

Corporate Headquarters Location(Required)

City State / Province / Region

What approximate percent of product content is composed of Wisconsin cost inputs?(Required)

Please enter a number from 0 to 100.

How many years have you been in business?

Annual Total Sales(Required)

Name of your Commercial Bank(Required)

Name of your Commercial Banker contact(Required)

Name of your Trade Finance Bank, if different than your Commercial Bank

Your Dun & Bradstreet Number(Required)

Dun & Bradstreet Number can be found at www.dnb.com

Your NAICS Code(Required)

This is the North American Industries Classification Systems (NAICS) number that describes what your company does. If you do not know your NAICS code, please 1) Check your Dun&Bradstreet listing; and/or 2) Search for the applicable code at https://www.census.gov/eos/www/naics/

Your Harmonized Code/Schedule B number, if known

This is a 10-digit number describing your product. It is an internationally standardized product classification code system. Often called the Harmonized System or HS Code. You can often find yours on current shipping documents you are submitting. More info at: https://www.trade.gov/harmonized-system-hs-codes

Electronic Signature

Name(Required)

First Last

Date(Required)

What is four plus 7?(Required)

Please enter a number from 11 to 11. Your answer should be a two-digit number, such as "42."

Contact us for a free consultation!

Get In Touch

ExporTech™ Scholarship Application