MAST Americas 2011, Washington, D.C.

November 14 – 16th, 2011

TRADE MISSION APPLICATION

1. MISSION DELEGATE STATUS

Completion of this application form does not imply acceptance as a trade mission participant. Applicants will be screened for final selection.

I am applying to participate on the MAST Americas trade mission, dated November 14-16th, 2011 as (check one only):

□ Business Delegate, Type 1 - Booth Display at MAST and Business Matchmaking

□ Business Delegate, Type 2 - Booth Display at MAST, No Business Matchmaking

□ Associate Delegate - No Booth Display at MAST, No Business Matchmaking

2. COMPANY INFORMATION

Company Name: ______

Mailing Address: ______

City/Town/Province: ______

Postal Code: ______

Telephone: ______

Fax: ______

E-mail: ______

Web site: ______

MISSION DELEGATE INFORMATION

PRIMARY DELEGATE

Name and Title: ______

Cellular: ______

E-mail: ______

ADDITIONAL DELEGATE (if applicable)

Name and Title: ______

Cellular: ______

E-mail: ______

For additional delegates, please copy this page and submit with application.

3. EXPORT EXPERIENCE

PLEASE IDENTIFY YOUR COMPANY’S EXPORT EXPERIENCE: (check one)

□ Export-ready

□ Experienced exporter, but new to this market

Where are you currently exporting? ______

□ Currently doing business in this market, but interested in expanding

BUSINESS PROFILE

To assist us in evaluating your application, please provide us with a business profile which includes the information identified in the headings below. If not submitting this form via email - please send your company profile electronically (CD or e-mail).

·  BUSINESS PROFILE

Provide brief description of your company and business activities.

·  PRODUCTS AND/OR SERVICES

Describe your products/services, highlighting those you will be promoting in the market.

·  BUSINESS OBJECTIVES

Describe your desired business objectives for this mission.

INDUSTRY SECTOR

Please identify the industry sector which best fits your business activities. If more than one applies, please rank by numbers (1 being the highest/main interest, 2 for secondary, etc.).

INFORMATION AND COMMUNICATION TECHNOLOGY
OCEAN TECHNOLOGY
AEROSPACE & DEFENCE
OTHER (please identify)

4. APPLICATION FOR FINANCIAL TRAVEL ASSISTANCE

 □ I WISH TO APPLY FOR FINANCIAL ASSISTANCE (TRAVEL)

 □ I DO NOT WISH TO APPLY FOR FINANCIAL ASSISTANCE (TRAVEL)

NOTE: Until further notice, as dictated by funding (Pending through INTRD) available, please be advised that the maximum provided to any company participating will be:

Market Assistance Funding: 50% of the following:

Airfare: Up to $2,500 per Company

Accommodations: Up to $1,500.00 per Company

5. MISSION FEES

DESCRIPTION UNIT AMOUNT TOTAL

Mission Fee per Company Bus. Delegate Type 1 $ 1,000.00 $1,000.00

Mission Fee per Company Bus. Delegate Type 2 $ 500.00 $ 500.00

Mission Fee per Company Associate Delegate $ 250.00 $ 250.00

Reception at the Canadian Embassy Included

IDENTIFY ANY OTHER SOURCES AND AMOUNTS OF FUNDING WILL BE USED TO SUPPORT YOUR APPLICATION:

______

PROVIDE ANY SUPPLEMENTARY INFORMATION WHICH YOU FEEL IS RELEVANT TO YOUR APPLICATION:

______

PLEASE FORWARD YOUR APPLICATION TO:

Natasha Hudson, Business Development Coordinator

NATI - Accelerating the Business of Technology

391 Empire Ave, Suite 5,St. John’s NL, Canada A1E 1W6 Tel. (709) 757-3253

2