Application for Economic Development Professionals
Organization Information
Organization Name
Organization Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Do you have multiple locations?
Yes
No
Number of Staff
Full and Part Time
Number of Independent Contractors
Number of Service Providers
Which Program Are You Applying For (Select All that Apply)
ISM Licensed Programming
1-on-1 Executive Coaching
Capacity Building Tour
Coaching and Mentorship
Mastermind
Professional Development
Training-the-Trainer
Other
Why do you want to join this program?
List expectations
My organization supports:
*
Idea Stage Entrepreneurs
Tech-Based Entrepreneurs
Launch Stage Entrepreneurs
Place-Based Entrepreneurs
Growth Stage Entrepreneurs
Service-Based Entrepreneurs
SME Enterprise Owners
Home-Based Entrepreneurs
International
Retail-Based Entrepreneurs
Underserved
General Public
Underrepresented
Student Body
Underresourced
Immigrants
Underpriviledged
Privildged
Special Needs
Minority
Women
LGBTQ+
Other
My organization offers programs such as:
Acceleration
Mentorship
CoWorking Space
Training
Funding and/or Access to Funding
International Soft-Landing Programs
Incubation
Workshops
Matchmaking
Other
Are you Membership Driven?
*
Yes
No
Are you affiliated with a Smart Zone?
*
Yes
No
Are you affiliated with a University?
*
Yes
No
Are you on or off Campus?
*
On
Off
Type
*
For Profit
Non Profit
My organization is funded by:
*
Grants
Revenue Generation
Foundation / Philanthropic
Other
Revenue Range
*
Under $500,000
$500,001 - $1,000,000
$1,000,001 - $5,000,000
$5,000,001 - $25,000,000
Over $25,000,000
Demographics
Name
*
E-mail
*
example@example.com
Phone Number
*
Format: (000) 000-0000.
Personal Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please select the Title(s) that best describes you
*
Dr. / Rev. / etc.
Mr. / Sir / etc.
Mrs. / Miss / etc.
Mx / No Title / other
Please select the Ethnicity(ies) that best describe you
*
Asian
Native American/ Indigenous
Black
Swana
Caucasian
Prefer Not to Say
Hispanic
Other
Education Level
*
High School or Equivalent
Bachelors Degree
Some College
Master's Degree
Associates Degree
Doctorate
Other
Economic & Workforce Development
Economic Development is used to foster: (check all that apply)
*
Entrepreneur / Small-Medium Enterprises (SME)
Entrepreneur Support Organizations (ESO)
Workforce Development
Economic Development Organizations (EDO)
Incubator/Accelrator/HUB
Smart Zones
Tech Transfer Offices (TTO)
Angel Investors / Venture Capital (VC's)
Other
Tax Credits or Incentives are part of the Economic Development
*
Yes
No
Rank the categories that support Entrepreneurship Ecosystem & SME Development
*
Rows
1
2
3
4
5
College Grads
Interns
Professionals
Mentors
Coaches
Consultants
Business Advisors
Other
Entrepreneurship Ecosystem
What is the lifetime of entrepreneurship ecosystem development?
*
0-5 years
5-10 years
20+ years
How many components are there of the entrepreneurship ecosystem?
*
4
7 or More
5
I don't know
6
Other
What is entrepreneurship? (check all that apply)
*
Someone with an idea
A startup
Small Business
A Mindset
Small Business Owner
A Founder
Employee in a large business
Other
SME Development
What is more important for SME Development rank?
*
Rows
1
2
3
4
5
Funding
Talent
Access to RFPs
Access to
International Market
Operation Excellence
Most SME Owners have:: (check all that apply)
*
Finances under control
Operation excellence
Good credit
More than 2 employees
Economic Gardening
Economic Gardening is important for: (check all that apply)
*
Large Corporations
Entrepreneurship
Small Business
Application Submission
By submitting this application, I agree that I will participate in the professional development program and am committed to not only receiving information but also sharing information.
*
Yes
No
Upon approval:
*
I am able to pay the up to $5,000 training investment
My organization will pay up to $5,000 in training investment
I will need a partial scholarship but am able to pay some of the program investment
I will need a full scholarship
I am nominated by an economic development agency or a group such as: incubators, accelerators, innovation hubs, universities, or other agencies.
*
Yes
No
Others within my organization who should have access to this program and/or application.
Please provide contact information for anyone else who should be involved in our conversations. Or who should be sent this application.
Submit
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