"*" indicates required fields Applicant Information (only 1 application per company is allowed)1. Applicant Name*(PI on proposed application) First Last Phone Number*Alternate PhoneEmail Address* Enter Email Confirm Email 2. Applicant role within company (e.g. Founder, CEO, Senior Scientist, etc.)*3. Stage 1 requires at least 2 team members. Who will serve as the additional team member for Stage 1?*4A. Please enter the name of your company (note: the company must be established prior to applying)*4B. Please enter the structure (e.g. LLC or Corporation) of your company here*5. Where is the operating location of the Small Business?* Street Address Address Line 2 City ZIP / Postal Code State*AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingAmerican SamoaFederated States of MicronesiaGuamMarshall IslandsNorthern Mariana IslandsPuerto RicoPalauVirgin Islands6. Will a University be affiliated with the project?* Yes No 7. Are you seeking support to help prepare a new NIH SBIR/STTR application or to assist you in resubmitting an amended application?* New Application Resubmission If a resubmission, please enter previous grant number.8. Does the small business or Principal Investigator (PI) have an NIH SBIR/STTR application with the same scope of work under review?* Yes No 9. What is the previous experience of the small business with NIH SBIR/STTR funding?* Have not applied Have not been successful Have received NIH SBIR/STTR award(s), with award years in 2015 or later (Ineligible for STEP) Have received NIH SBIR/STTR award(s), with the most recent award received prior to 2015 (Eligible for STEP) 10. What is the previous experience of the proposed project PI with NIH SBIR/STTR Funding?* Have not applied Have not been successful Have received NIH SBIR/STTR award(s) 11. Have you interviewed potential customers for your proposed technology to better understand their current pain points and needs?* None – for example, our team members have not identified potential customers for our proposed technology Very Little – for example, our team members have identified potential customers, but have conducted no interviews Some – for example, our team members are in the early stages of interviewing potential customers A Great Deal – for example, our team members have interviewed multiple customers and/or we have participated in formal customer discovery through a program such as I-Corps 12. What is the experience of the small business in translating technologies from discovery to commercialization?* None – for example, no team members have commercialized a technology before or have formal training in doing so Very Little – for example, no team members have commercialized a technology before, but one or more have formal training in doing so Some – for example, one or more team members have contributed to the commercialization of a technology before and/or have substantial formal training in doing so A Great Deal – for example, one or more team members have commercialized technologies before and/or have substantial formal training in doing so 13. Who is your intended customer and/or end user?*Technology Information14. What type of technology will you be developing in your proposed SBIR/STTR project?* Therapeutics (e.g., Small Molecules, Biologics, Radiomodulators, Gene/Cell-based Therapies and Drug Development-Related Tools, and Algorithm Development) In Vitro and In Vivo Diagnostics (e.g., Companion Diagnostics, Prognostic Technologies, Treatment Monitoring and Diagnostic-Related Tools, and Algorithm Development) Imaging Technologies (e.g., Agents, Devices, Software Tools, Algorithm Development, and Image-Guided Interventions) Devices for Cancer Therapy (e.g., Interventional Devices, Drug Delivery Devices, Software Tools, Algorithm Development, Surgical, Radiation, and Ablative Therapies) Agents for Cancer Prevention (e.g., Vaccines, but not “Technologies for Cancer Prevention”) Development of Low-Cost Technologies for Low-Resource Settings and Cancer Global Health Development of Digital Health Tools Other if other, please specify15. Project Title (limit 200 characters)*16. What is the NCI-related public health problem or indication that you are addressing? (Up to 1,500 characters)*Note: NCI's mission is to lead, conduct, and support cancer research across the nation to advance scientific knowledge and help all people live longer, healthier lives. 17. The Technology Innovation. (Up to 1,500 characters)*What is the envisioned end product or service? Does the proposed product or service represent an innovative approach to addressing an important problem, barrier to progress, or unmet need in research or clinical practice? What are the significant advantages over existing approaches or methodologies, instrumentation, or interventions or those in development?18. Describe the current state of your technology (i.e., concept, prototype phase, in vitro testing, etc.). (Up to 200 characters)*19. Describe the premise that supports the scientific rationale for your proposal (upload 1-page pdf only)*Accepted file types: pdf, Max. file size: 64 MB.20. NIH SBIR/STTR Phase I Goals and Milestones. This should reflect a scope of work that can be accomplished in a Phase I SBIR/STTR project that is up to 1 year within a budget of up to $400,000. (Up to 3,000 characters)*21. Describe your strategy to protect your technology from competitors (i.e., patents, copyright, etc.). (Up to 500 characters)*Network and resources for SBIR/STTR application development22. What level of access do you have to entrepreneurship training resources?* None – for example, none of our team members have attended entrepreneurship training courses, and we do not have access to these resources in our research environment Very Little – for example, our team members have not attended entrepreneurship training courses, but we may have access to these resources in our research environment Some – for example, our team members have attended entrepreneurship training courses, and/or we have access to substantial resources in our research environment A Great Deal – for example, our team members have formal training or expertise in entrepreneurship and we have access to substantial related resources in our research environment 23. What is your experience level with registrations (e.g., SAM, eRA Commons, grants.gov) and level of access to registrations support-related resources?* None – for example, our team has never completed federal registrations and we do not have access to registrations support for SBIR/STTR applications Very Little – for example, our team has attempted SBIR/STTR-related registrations before, but need formal guidance to complete them Some – for example, our team has completed relevant registrations before and need feedback on whether these are compliant for SBIR/STTR applications A Great Deal – for example, our team has completed all relevant registrations and/or already have access to registrations support 24. What is your experience level with proposal writing and development and/or do you have access to related resources?* None – for example, our team has never written grant proposals and do not have access to proposal development resources in our research environment Very Little – for example, our team has limited experience and resources related to proposal development and need formal guidance Some – for example, our team has some experience preparing proposals and has access to related resources, but need feedback and further guidance on developing a competitive SBIR/STTR proposal A Great Deal – for example, our team is very experienced in preparing proposals and has secured grant funding previously 25. What is your level of expertise in technology development?* None – our team has not developed a technology before Very Little – for example, our team has limited experience with technology development and need formal guidance Some – for example, our team has experience developing technologies unrelated to the proposed technology and need feedback and further guidance with the proposed technology development A Great Deal – for example, our team is very experienced in technology development, including the proposed technology 26. How much experience or support resources do you have in relation to proposal upload and submission?* None – for example, our team has never uploaded and submitted a proposal before and does not have access to any support or resources for this purpose Very Little – for example, our team has limited experience with proposal upload and submission, and we need formal guidance Some – for example, our team has experience uploading and submitting proposals for other federal grant solicitations, we and need feedback and further guidance with SBIR/STTR proposal upload and submission A Great Deal – for example, our team is very experienced in proposal upload and submission 27. The NCI STEP is an intensive 16-week program, requiring 1) weekly group webinar attendance, 2) engaging in personalized 1:1 coaching and small group meetings weekly, 2) developing your business model, 3) interviewing stakeholders including potential end users, purchasers, and partners to validate hypotheses of your value proposition, 4) developing and submitting a Phase I SBIR/STTR application. Do you agree to spend 10-25 hours per week during the training period working on your business model and customer interviews in Stage 1 and developing your SBIR/STTR application in Stage 2?* Yes No CAPTCHA Before submitting, please ensure that your email address and phone number have been accurately entered, as they will be used to notify you regarding your application status. Δ
