Application

Date*

Name of Company*

Company Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Contact Name

First Last

Email*

Phone

Description of Company’s Operations:

Company Website

Ownership

Form of Business

Location of corporate headquarters:

Is your company registered to do business in Texas?

How long has the company been in operation?

Location of the proposed or existing facility in Lufkin:

Description of project:

The company’s primary North American Industry Classication System (NAICS):

Example: 221119. A six-digit NAICS code should be entered for an economic impact analysis

The project’s estimated total capital investment:

Number of Full Time jobs to be created:

Tell us more about the project, select all that apply: