Small Business Program Application Form

LSAS Small Business Program Application Form

Customer Information:

Company Name

DBA

Federal TaxID

Street Address

City

State

Zip

Phone

Website

Applicant Name

Applicant Email

Title

Business Type

Years In Business

Parent Company (if applicable)

Eligibility Requirements:

Please confirm your company’s eligibility to join the LSAS Small Business Program by answering the following questions. If you cannot answer “Yes” or “No” to any of the questions below, please provide an explanation in the “Other” field for consideration.

Is your company privately held?

Is your company a new division or a wholly owned subsidiary of a pre-existing company?

Is your company less than ten (10) years old?

What is your company’s annual revenue?

How much funding has your company received or raised?

Is your company an existing Ansys commercial customer?

Is your company an engineering services or engineering consultant company?

By entering your name below, you are confirming your answers to the questions and commitments identified above.

Signature

Date