Growth Acceleration Service Application

Full Name:
Title:
Company Name:

Mailing Address

Street
Suite/Apt.
City
State
Zip
County Alachua CountyBaker CountyBay CountyBradford CountyBrevard CountyBroward CountyCalhoun CountyCharlotte CountyCitrus CountyClay CountyCollier CountyColumbia CountyDade CountyDeSoto CountyDixie CountyDuval CountyEscambia CountyFlagler CountyFranklin CountyGadsden CountyGilchrist CountyGlades CountyGulf CountyHamilton CountyHardee CountyHendry CountyHernando CountyHighlands CountyHillsborough CountyHolmes CountyIndian River CountyJackson CountyJefferson CountyLafayette CountyLake CountyLee CountyLeon CountyLevy CountyLiberty CountyMadison CountyManatee CountyMarion CountyMartin CountyMonroe CountyNassau CountyOkaloosa CountyOkeechobee CountyOrange CountyOsceola CountyPalm BeachCountyPasco CountyPinellas CountyPolk CountyPutnam CountySanta Rosa CountySarasota CountySeminole CountySt. Johns CountySt. Lucie CountySumter CountySuwannee CountyTaylor CountyUnion CountyVolusia CountyWakulla CountyWalton CountyWashington County

Business Information

Street
Suite/Apt.
City
State
Zip
County Alachua CountyBaker CountyBay CountyBradford CountyBrevard CountyBroward CountyCalhoun CountyCharlotte CountyCitrus CountyClay CountyCollier CountyColumbia CountyDade CountyDeSoto CountyDixie CountyDuval CountyEscambia CountyFlagler CountyFranklin CountyGadsden CountyGilchrist CountyGlades CountyGulf CountyHamilton CountyHardee CountyHendry CountyHernando CountyHighlands CountyHillsborough CountyHolmes CountyIndian River CountyJackson CountyJefferson CountyLafayette CountyLake CountyLee CountyLeon CountyLevy CountyLiberty CountyMadison CountyManatee CountyMarion CountyMartin CountyMonroe CountyNassau CountyOkaloosa CountyOkeechobee CountyOrange CountyOsceola CountyPalm BeachCountyPasco CountyPinellas CountyPolk CountyPutnam CountySanta Rosa CountySarasota CountySeminole CountySt. Johns CountySt. Lucie CountySumter CountySuwannee CountyTaylor CountyUnion CountyVolusia CountyWakulla CountyWalton CountyWashington 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

Total Revenues/Sales:
2020: $
2021: $
2022: $

2023 Projection: $

2022 Total Assets: $
2022 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:
2020:
2021:
2022:

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?