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Format: (000) 000-0000.
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- 13. Legal Company Structure ?*
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- 19. Are any founders covered by non-competes or intellectual property agreements that are shared with your company?*
- 20. Are you full-time or part-time in your business?*
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- 22. What year did you incorporate your business?*
- 23. Please check the box next to the description that best describes your industry.*
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- 25. What is the operational stage of your business?*
- 26. Does your business have any of the following certifications? Check all that apply.*
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- 28. Income from this business is my primary income source.*
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- 33. Are you currently using a Financial Management System?[ i.e. Quickbooks, Xero, or Wave]*
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- 34. Are you able to produce Income Statements and/or Cash Flow Statements and Reports*
- 35. Do you have up-to-date Financial Projections?*
- 36. Do you have a Pitch Presentation?*
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- 47.a. Do you have a business checking account?*
- 47.b. Have you ever received outside financing?*
- 47.c. Do you have an accountant?*
- 47.d. Do you have a bookkeeper?*
- 47.e. Do you have business credit with suppliers?*
- 47.f. Do you have or have you ever had a business coach?*
- 47.g. Do you produce an annual budget?*
- 47.h. Do you make estimated tax payments?*
- 47.i. Are you current on your income taxes?*
- 47.j. Are you current on your payroll taxes?*
- 47.k. Do you have an internal or external bookkeeper?*
- 47.l. Do you have business cards?*
- 47.m. Do you have a customer relationship management (CRM) system?*
- 47.n. Do you have a thirty-second pitch?*
- 47.o. Do you utilize social media to market your business?*
- 47.p. Do you have a documented customer acquisition strategy?*
- 47.q. Do you have a documented marketing strategy?*
- 47.r. Do you have a documented operations plan?*
- 47.s. Have you ever done a business plan for this business?*
- 47.t. Do you have an up-to-date business plan for this business?*
- 47.u. Do you have a documented talent acquisition / talent development/ talent management strategy?*
- 47.v. Do you have an internal or external human resources manager?*
- 47.w. Do you have an employee handbook?*
- 47.x. Do you have business liability insurance?*
- 47.y. Do you have business property insurance?*
- 47.z. Do you have any intellectual property protections?*
- 47.a1. Are you licensed to do business in the City where your business is located?*
- 48. What have been the most limiting factors for your business growth? (Select the top 4)*
- 49. Select the top 4 areas with which you need the most assistance?*
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- 52. Are you looking for funding?*
- 52.a. What type of capital are you looking for?*
- 52.b. Have you filed your business taxes in the last year?*
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- 52.d. Will you need the capital in the next 6-12 months?*
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- 52.f. Do you currently have business debt?*
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- 52.f2. Are you seeking to refinance any existing debt?*
- 52.g. What will be the source of funding repayment? (Check all that apply)*
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- 52.l. Are you willing to exchange a percentage of ownership in your company for capital?*
- 52.m. Is your primary goal for this funding rapid growth that could lead to a future sale of your business (acquisition) or taking it public (IPO)?*
- 52.n. Are you comfortable providing regular, detailed financial and operational reports to investors?*
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- 56. Is there anyone in your circle who owned a business who was an example or role model for you?*
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- 59. Select the top 3 reasons you started/acquired your business:*
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- 69. Enter your date of birth:*
- 70. Gender*
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- 72. Ethnic Identity*
- 73. Racial Identity:*
- 74. Are you a U.S. Citizen?(Answer will not affect application)*
- 75. Is English your primary language?*
- 76. Educational background*
- 77. What is your household income from all sources?*
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- 79. Do you identify as any of the following?
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- Should be Empty: