Santander Business Growth Scholarship Application

The purpose of this scholarship, funded by a grant from the Santander Consumer USA Foundation, Inc., is to support the local entrepreneur ecosystem specifically as it relates to women and minority-owned businesses headquartered in Pasco County, Florida through a scholarship opportunity of up to $3,600 per recipient. Each applicant Is only eligible to receive one Santander Business Growth Scholarship.

Scholarships are awarded based solely on
eligibility and availability of funds.

Receiving a scholarship does not imply endorsement of views, opinions, or guarantee success, of the recipient by either The Santander Consumer USA Foundation, Inc. or the Pasco Economic Development Council, Inc.

Applicant Name

First NameLast NameTitle

Phone Number

Area CodePhone Number

Mobile Phone Number

Area CodePhone Number

E-mail Address

example@example.com

Website Address

www.example.com

Home Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Business Name (if applicable)

Company Structure

Company Type (Ex: Bakery):

Business Address (Must be Pasco County Headquartered Business)

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

For which Program or Programs are you seeking financial assistance?

CO.STARTERS

Session Location / Date

Entrepreneur Roundtable

Roundtable Location

Date

Incubator Program

Entrepreneur Center Location

Type of Membership

Monthly Cost of Membership

Duration of Scholarship

Planned Membership Start Date

TOTAL Scholarship Requested (Maximum $3600)

Eligibility Determination

Eligibility Determination (Please select one):

Gender (Please select one):

Other

What will your company do (Description of Products/Services)?

What is holding you back from getting your business started or growing?

How will your business diversify the economic base of Pasco County? Are there any social impacts your company will have?

How will this scholarship assist your business and how do you plan to measure your success?

Acknowledgement & Signature

Date

Authorized Signature

Printed Name

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