Embed Size (px)
Citation preview
EXPORT MARKETING ASSISTANCE SERVICE (EMAS) APPLICATION FORM
1. Company Name: ___________________________________________________________________
2. Address (include Street, City, State, Zip Code): ___________________________________________
_________________________________________________________________________________
3. Telephone: __________________________ 3a. Fax: ____________________________
3b. e-mail: __________________________ 3c. Website: _________________________
4. Contact Person: ______________________________ 4a. Title: ____________________________
5. Annual Sales: ________________ 6. Number of Employees: __________ 7. Year Founded: _________
8.
8a.
New to Export (No export experience) ____ OR
Market Expansion (Currently export to one or more markets) ____
Percentage of current annual export sales: _____ %
1 of 4
____ Jewelry Manufacturing ____ Products and Service Technologies ____ High-Tech Electronics, Software/ IT
& Communications Nanotechnology ____ Other ____________________________
__________________________ __________________________
11. Company Activity (check all that apply):___ Manufacturer ___ Distributor ___ Service Company ___ Economic Development Organization___ Other (specify) __________________________________________________
12. Industries (check all that apply):
9a. Size (in sq. feet)
___ Aerospace, Aviation & Defense___ Advances Materials & Chemicals ___ Agriculture & Processed Foods ___ Beer, Wine & Spirits ___ Biotech Medical Devices & Life Sciences ___ Clean Technology, Recycling
& Renewable Energy
2019-02
9. Plant Location(s):____________________________________________________________
10. Check all that apply:
☐ Yes ☐ No___ Minority-Owned
___ Veteran-Owned
___ Disabled Veteran-Owned
___ Woman-Owned
___ Rural Business
10a.
If yes, are you a NY State certified MWBE?
17. Which complementary product lines would normally be carried along with your own?
18. What are the usual distribution pattern(s) and sales channels for your products and/or services?
2 of 4
13. PRINCIPAL ACTIVITY/ PRODUCT LINES
______________________________________________
_______________________________________________
PRINCIPAL APPLICATIONS/(End Users)
________________________________
________________________________
Harmonized Codes, if known
NAICS, if known________________________________
__________________________________________
14. Provide a brief company description:
15. Which trade show(s) do you/have you participated in?
16. Profile of an Ideal Agent or Distributor:(Technical and marketing capabilities; facilities; after-sales service; spare parts. etc.):
19. Who are the principal U.S. and foreign competitors?
3 of 4
West Africa: East Africa ☐ Ghana ☐ Kenya
☐ Uganda☐ Rwanda☐ Tanzania
23. We are applying for EMAS participation in the following market(s): Select a maximum of 2 markets.
☐ ISRAEL☐ CANADA
☐ MEXICO
☐ CHINA
☐ AFRICA
☐ EUROPE
☐ OTHER: ____________________________
23a. If you selected Africa for question 23, please select one country from the following list:
Southern Africa: Indian Ocean ☐ South Africa☐ Namibia☐ Botswana☐ Swaziland☐ Lesotho☐ Zambia
☐ Mauritius☐ Madagascar☐ Seychelles☐ Comoros☐ Reunion (Region of France)
☐ Malawi☐ Angola☐ Zimbabwe☐ St Helena☐ Mozambique
22. We are seeking (check appropriate items): Agents_______ Distributors_______Other______________________________________Local Intelligence for market _______
20. What are the special selling points and advantages (including patents, trademarks, etc.)?
21. Which countries do you currently export to?
24. Please indicate previous or present representation, export sales efforts, successes, and problem areas (ifany) to date in the markets selected above:
Signature of Authorized Company Official: _________________________________ _
Print Name: ______________________________________
Date: _________________
Print Title: __________________________________
Please e-mail the completed EMAS application form to [email protected].
Empire State Development, Global NY633 Third Avenue
New York, NY 10017
4 of 4
23b. If you selected Europe for question 22, please select one country from the following list:
Western Europe:
☐ Benelux(Belgium, the Netherlands and Luxembourg)
☐ France
☐ Germany
☐ Ireland
☐ Italy
☐ Spain
☐ United Kingdom
Central Europe/New EU markets:
☐ Baltics(Estonia, Latvia and Lithuania)
☐ Czech Republic/Slovakia
☐ Hungary
☐ Poland
Scandinavia: ☐ Denmark
☐ Finland
☐ Norway
☐ Sweden
Emerging Eastern Europe: ☐ Bulgaria
☐ Romania
☐ Russia
Certification of Authorized Official: I hereby certify that the products for which representation is sought under EMAS are produced in New York State.
