Entrepreneurship Training Program(s) Application

Entrepreneurship Training Program Application
Are you an ESO or EDO? Fill out this application instead

http://ecosystemclub.com/
- Your Name:*
  
  First Name Last Name
- Address*
  
  Street Address
  
  Street Address Line 2
  
  CityState / Province
  
  Postal / Zip Code
- Country*
- Personal Email Address:*
  Please enter an Email our Team can contact you at to Schedule a Meeting
- Phone Number:*
  Include Area and / or Country Code if applicable
- Please upload a headshot
  
  Browse Files
  
  Cancelof
- Which Program Are You Applying For (Select All that Apply)*
  
  Kauffman FastTracResilient EntrepreneurCapital & Finance ReadinessExploring EntrepreneurshipMastermind for EntepreneursTrain the TrainerPower of 7 in MarketingCapacity Building ToursGlobal Trade MissionBusiness CoachingOther
- Please write a short bio about yourself.*
  
  0/75
- Have you participated in any other business plan, incubator or other business development program?*
  
  YesNo
- Which programs *
- Have you participated in any professional exchange programs in the U.S or other countries?*
  
  YesNo
- What do you hope to learn or get out of this program?*
  
  0/50
- Why should we accept you to the program?*
  
  0/50
- What financial resources do you have to complete the program
  
  0/50
- Business Name*
- Business Locations*
- Business Logo*
  
  Browse Files
  
  Cancelof
- Please write a short description about your business *
  
  0/125
- What products / services do you offer and/or manufacture?*
  
  0/50
- What makes your product/service unique?*
  
  0/150
- What problem are you solving? *
  
  0/50
- Describe your customer. *
  
  Age, gender, culture, etc.0/50
- What industry best describes your business?*
  
  Business Services (Consulting, Staffing, Finance, Legal, etc)Consumer Retail (Clothing, Goods, etc)Food & RestaurantHealth, Medical or FitnessManufacturing/ConstructionTechnology (Hardware, Software, Service)Other
- Do you consider your business to be:*
  
  Tech-BasedPlace-BasedBoth
- What stage is your business in?*
  
  Idea Stage: I am exploring Entrepreneurship and I am thinking about starting a businessStartup: I have some paying customersGrowing: I am generating some revenue. Help me quit my day job!Scaling: I am working full time in my business and need to expand
- How many employees do you have? *
  Please include part-time/full-time
- Is this a family business?*
  
  YesNo
- Is your business currently operational?*
  
  YesNo
- What were your sales revenues for the last fiscal year*
- What are your most up-to-date sales for this fiscal year?*
  If sales are 0, you may state that here
- What percentage did your sales increase/decrease by compared to the previous year?
- What trends have you seen that affect growth in your business? *
  
  0/100
- Do you advertise/market your business?*
  
  YesNo
- How do you advertise/market? *
  
  0/50
- What are your Short-Term Goals for the business?*
  
  0/75
- What are your Long-Term Goals for the business?*
  
  0/75
- Do you currently have a business plan?*
  
  YesNo
- Upload Business Plan
  
  Browse Files
  
  Cancelof
- What steps have you taken?*
  
  0/75
- Please select the Title(s) that best describes you
  
  Mr. / Sir / etc.Mrs. / Miss / etc.Dr. / Rev. / etc.Mx / No Title / otherOther
- Please select the Ethnicity(ies) that best describe you*
  
  AsianNative American/ IndigenousBlackSwanaCaucasianPrefer Not to SayHispanicOther
- Immigrated to the US?
  
  YesNoPrefer Not to Say
- Which generation emigrated to the US?
  Myself, Parents, Grandparents, etc.
- Highest Education level completed
  
  High school diploma/GEDBachelor's DegreeSome CollegeMaster's DegreeAssociates DegreeDoctorateOther
- Income Level
  
  Under $10,000$10,000 - $40,000$40,000 - $85,000$85,000 - $165,000$165,000 - $210,000$210,000 - $525,000Over $525,000
- Signature*
- Any additional thoughts or remarks?
- Do you have a passport with which to travel? Passports must be valid through at least December 2023
  
  YesNo
- Please refer to the list of acceptable vaccines as per the FDA and WHO
  
  CDC Accepted COVID-19 Vaccines
- Do you have proof of Covid-19 Vaccination (single series or 2-dose series vaccines, booster shots not needed) approved by the CDC for travel?*
  
  YesNo
- List which type of vaccine and the dates you received both doses /
- I understand that neither ISM nor EFE are responsible for any additional costs if I decide to extend my trip / Signature /
- Should be Empty:

Entrepreneurship Training Program Application