Indicates required field Company Name Company Name Contact Full Name Contact First Name Contact First Name Contact Last Name Contact Last Name Contact Title Contact Title Contact Phone Contact Phone Please include area code. Contact E-mail Contact E-mail Type of Inquiry Type of Inquiry - None -Space and Property InquiryMaintenance Request Space and Property Inquiry Company Website Company Website Are the company principals(s) Rensselaer alumni? Are the company principals(s) Rensselaer alumni? - None -YesNo Are you interested in leasing space in a multi-tenant building? Are you interested in leasing space in a multi-tenant building? - None -YesNo Do you anticipate the use of hazardous chemicals? Do you anticipate the use of hazardous chemicals? - Select -YesNo Are you interested in building your own facility? Are you interested in building your own facility? - None -YesNo Please select your anticipated space usage need(s): Office space Light industrial / manufacturing Warehouse Wet laboratory Other… Enter other… Enter other… Please enter the approximate number of employees who will be working at this location in the first year of occupancy: Please enter the approximate number of employees who will be working at this location in the first year of occupancy: Please describe any specific requirements or special needs you will require for the space: Please describe any specific requirements or special needs you will require for the space: Loading dock, ceiling height, parking, etc Maintenance Request Your Tech Park address: Your Tech Park address: Please include building and number. Please select the type(s) of problem you are experiencing at your location: Electrical / fixtures Heating / air conditioning / air quality Roof or ceiling leak Facility plumbing / bathrooms / kitchen areas Pest or animal control Snow or ice hazard Trash or litter Other… Enter other… Enter other… Please describe the maintenance or repair issue below: Please describe the maintenance or repair issue below: Leave this field blank Leave this field blank