Small Business Accelerator (SBA) Program Application Form
Our program runs throughout the year. Once we have the dates for the next cohort confirmed, we will contact you. Please submit your application which will be placed on the waiting list.
Please note we can only accept applicants from Ontario.
PERSONAL & CONTACT INFORMATION
Thank you for applying for the Small Business Accelerator Program (SBA)
First Name
*
First Name
Last Name
*
Surname
Age range
*
18-29
30-45
46-54
55+
Email
*
example@example.com
Cell Phone
*
Please enter a valid phone number.
Home/Other Phone
Please enter a valid phone number.
Residential Address
*
Unit, Number, Street
City
*
Postal Code
*
Example: M4T 1Z6
Province
*
Please Select
ON
Other
How did you hear about this program?
*
Please Select
ACCESS staff
ACCESS client
Friend
Online (social media/website etc.)
Community agency (please note source below)
Other (please specify below)
Community Agency/Other (please specify referral source here)
What is your status in Canada?
*
Citizen
Permanent Resident
Convention Refugee/Protected Person
Other (please note in the section below)
If you selected other above, please fill in this section
What is your country of origin?
*
Country of Origin
How long have you been in Canada?
*
Under 1 year
1-5 years
6-10 years
More than 10 years
Born here
Gender
*
Please Select
Male
Female
Non-Binary
Prefer not to say
Which category/categories best describes you? (Please select all that apply)
*
Indigenous
Black (ex. African descent)
Latino (ex. Latin American, Hispanic descent)
Caribbean (ex. Bajan, Jamaican, Dominican, etc.)
East Asian (ex. Chinese, Korean, Japanese, Taiwanese, etc.)
Southeast Asian (ex. Filipino, Vietnamese, Cambodian, Thai, etc.)
South Asian (ex. Indian, Pakistani, Sri Lankan, etc.)
Middle Eastern (ex. Arab, Persian, Turkish etc.)
Central Asian (ex. Kazakh, Afghan, Uzbek, etc.)
White (European descent)
Multiracial/ethnic
Other
Prefer not to say
If you selected Other above, please specify it here.
Marital status:
Single
Married
Divorced
Widowed
Number of dependents (children):
0
1-5
6-10
More than 10
Annual Household Income (for you and your spouse/partner):
0-$10,000
$11,000-$20,000
$21,000-$30,000
$31,000-$40,000
$41,000-$50,000
$51,000-$60,000
$61,000-$70,000
$71,000-$80,000
$81,000-$90,000
$91,000-$100,000
Over $100,000
Level of Education
*
No formal education
Primary
Secondary
College or undergraduate
Post graduate
Employment status
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Full time
Part time
Self-employed
Not employed
Student
Business Ideas and Experience
We strongly encourage applicants to have at least one business idea they want to focus on and develop through this program. This could be an existing or a new business idea.
Do you have a business idea?
*
Yes
No
At what stage are you with your business idea?
*
Idea (no written business plan)
Early launch/growth (business operating for at least 3 months with or without a written business plan)
Briefly describe your idea or ideas (top two if you have more than one idea)
*
Description of business idea(s)
Have you owned and ran a business OUTSIDE Canada?
*
Yes
No
Do you currently own and run a business in Canada?
*
Yes
No
Business website/social media links, if applicable.
Business links
Have you previously participated in a business training program in Canada?
*
Yes (provide name below)
No
If you answered yes above, name of organization
Have you previously received business or professional coaching or mentorship?
*
Yes
No
Briefly tell us what you hope to gain from this program.
*
Funding Your Business
We facilitate loans up to $5,000 to individuals who meet our eligibility.
Will you be considering funding options for your business?
*
Yes
No
Not sure yet
If you answered yes to the previous question, what level of funding are you looking for?
*
$1,000-$5,000
$6,000-$10,000
More than $10,000
Program Attendance and Participation
To get the most out of the program, we strongly encourage commitment and attendance.
What may affect your ability to attend and complete the program? e.g. employment, school, childcare, the time of sessions, etc.
*
Are you committed and able to attend the program sessions?
*
Yes
No
Do you have access to a computer and reliable internet?
*
Yes
No
Media Consent and Release
As part of the program, we often do feature stories and profile our clients and their businesses. We would like your consent to share any content of those stories.
Do you authorize ACCESS Community Capital Fund to use your images or video footage, in whole or in part, individually or in conjunction with other images and video footage, to be displayed on its website and other official channels, and to be used for media purposes including promotional presentations and marketing campaigns? You agree to waive rights to privacy and compensation, which you may have in connection with such use of your name and likeness, including rights to written copy that may be created in connection with video production, editing and promotion therewith.
*
I agree
I do not agree
Today's Date
*
-
Month
-
Day
Year
Today's Date
Signature
*
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