CLIENT INTAKE FORM

Do you have a challenge you're looking to solve?

We may be able to help at the Centre for Applied Research, Innovation and Entrepreneurship (CARIE). Our team functions as a bridge between industry clients and the expertise of Lethbridge Polytechnic's (LP) dedicated researchers, faculty, and staff.

CARIE Bridge Process

The first step in our CARIE Bridge Process is the Client Profile Form (CPF) that assists us in matching your specific need with LP expertise and/or our Regional Innovation Network of Southern Alberta (RINSA) Partners.

If there is a potential match with LP, the next step may be a Bridge Meeting between the client, LP researchers, and the CARIE office to determine pathways for the project. Anyone interested in working with LP for research or technical services is required to complete a CPF.

CONTACT PERSON

First Name

Last Name

Phone Number

Email Address

How did you hear about Lethbridge Polytechnic?

COMPANY INFORMATION

Is this enquiry on behalf of an individual or company?

Individual

Company

Company Name

Are you a start-up?

Yes

No

Many programs fund or otherwise support projects at different stages of development.

These are the 9 TRLs, with 1 being the least ready and 9 being already used in real-life conditions.

Select the Technology Readiness Level (TRL) you are currently at:

Please provide a brief description of your company / organization or link to your webpage:

Job Title

What is the size of your organization?

Mailing Address

Town / City

Province / State

Country

Postal Code or ZIP

PROJECT DESCRIPTION

Please describe the specific challenge you are looking to solve:

Please select the LP research theme(s) that best aligns with the challenge you’ve described. This will allow us to assign the correct Operations Officer to assist you:

Hold CTRL and click to select multiple.

What is the timeline that you require for a solution?

Regional Innovation Network of Southern Alberta

We are also part of the larger Regional Innovation Network of Southern Alberta (RINSA)

that includes the following member organizations:

Alberta Innovates
Lethbridge College
University of Lethbridge
Tecconnect / Economic Development Lethbridge
Lethbridge Chamber of Commerce
Okotoks Economic Development
Piikani Resource Development
Blackfoot Confederacy Tribal Council Entrepreneurship Committee
Blood Tribe Economic Development
Community Futures Lethbridge Region
Southgrow Regional Initiative
Alberta Southwest Regional Economic Development
BIPOC Foundation
Rural Women Entrepreneurs in Technology
NRC-IRAP

RINSA collectively assists start-ups and small businesses to successfully navigate the

commercialization system through programs, services, and resources. As a part of the

Alberta Innovation Network, RINSA can leverage opportunities to collaborate with other

regional innovation networks throughout the province as well.

Have you been referred or spoke with any above RINSA partners?

Yes

No

If yes, who have you worked with?

If your project can benefit from the involvement of a RINSA partner, or if a referral is required, does CARIE have your permission to share the above information?

Yes

No

BUSINESS SECTORS

Which industry sector(s) is your company / organization associated with? Please select the top 2 applicable sectors.

Hold CTRL and click to select multiple.

Which sub-sector(s) is your company / organization associated with? Please select the top 2 applicable sectors.

Hold CTRL and click to select multiple.

Your personal information is being collected under the authority of subsection 33(c) of Alberta’s Freedom of Information and Protection of Privacy Act (FOIP) for the purpose of maintaining and managing customer relationships. It may be used and disclosed to other College departments and employees for this purpose, or for a use consistent with this purpose. If you have a question about the collection, use, disclosure, or protection of your personal information, please contact Lethbridge College’s FOIP Coordinator by phoning 403-320-3361, emailing privacy@lethbridgecollege.ca, or writing to 3000 College Dr. S., Lethbridge, Alberta, T1K 1L6 c/o FOIP Coordinator.