Growth Acceleration Service Application

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Is your business at least three years old? YesNo
Do you have at least five full-time employees or full-time equivalents? YesNo
Did your business generate at least $500,000 in sales last year? YesNo
Do you have the last three years’ financial reports readily available for review and analysis? YesNo
Do you want to grow your business? YesNo

Based on your answers, your business does not qualify for Growth Acceleration Services at this time. Please visit the Consulting page to learn how we can help your business.
Full Name:
Title:
Company Name:

Mailing Address

Street
Suite/Apt.
City
State
Zip
County

Business Information

Street
Suite/Apt.
City
State
Zip
County

Email Address:
Daytime Phone:
Website Address:
Business Start Date (mm/dd/yy):

Currently In Business: YesNo

Home-Based: YesNo

Business Type: RetailConstructionServiceManufacturingWholesaleOther

Business Description:

Business NAICS Codes (provide all that apply):

Gender: MaleFemale

Race: WhiteBlackHawaiian or Pacific IslanderAsianNative AmericanOther

Legal Structure: Sole ProprietorS-CorpPartnershipLLCCorporationUndecided

Hispanic: YesNo

Current # Employees:
Full
Part
1099

Veteran Status: Non-VeteranGulf War VeteranVeteranVietnam Era VeteranDisabled VeteranService-Connected Disability

Business Owner: Disabled or Handicapped? YesNo

Are you any of the following (Check all that apply)?
SBA BorrowerSBA ApplicantMBE Certified8(a) CertifiedSurety BondedImport/ExportHubZoneCOC

Financial Information

Total Revenues/Sales:
2015: $
2016: $
2017: $

2018 Projection: $
2019 Projection: $

2017 Total Assets: $
2017 Total Net Worth: $

Annual Profit (Loss): $ ProfitLoss

Do you currently have a positive cash flow? YesNo

How often do you receive financial reports (Income Statement & Balance Sheet)?

Is your accounting set-up on Accrual or Cash basis? AccrualCash

Total # EOY Employees:
2015:
2016:
2017:

Additional Comments:

Business Details

What are your main products and services?

Who are your largest customers?

Who are your major competitors?

How do you currently market your products/services?

What is your greatest challenge?

How do you hope to benefit from this service?

Do you have a business plan? YesNo
If yes what Date? (mm/dd/yy):

Do you have a strategic plan? YesNo
If yes what Date? (mm/dd/yy):

Do you have a budget? YesNo
If you have a budget, how often are variance reports reviewed?:

How did you learn about the service?