Linn -Benton Community College Small Business Development Center Program Scholarship Application
Please fill out this form for an opportunity to receive scholarship funds.
Name
*
First Name
Last Name
Email
*
example@example.com
Personal Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
Business Name
*
Business Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please give us a brief description of the business:
*
How long has your business been in operation?
Have you received services from this SBDC before?
Yes
No
If yes, please describe the services received below:
For which SBDC class would you like to be considered for scholarship? Pleas list the start date and the location.
*
The following demographic questions will help us determine eligibility for scholarship funds. Please answer as thoroughly and accurately as possible.
Are you on active duty in any branch of the military?
Yes
No
Are you a veteran of the US Military?
Yes
No
Is this business more than 50% woman owned?
Yes
No
Do you identify as Hispanic/Latino?
Yes
No
Do you consider English to be your second language?
Yes
No
Please describe in 300 words or less why you are interested in participating in an SBDC program, why are deserving of a scholarship, and how would this scholarship help you financially
*
Scholarship funds are very limited. Not all applicants will receive a scholarship. I agree to hold the LBCC SBDC harmless in the event that I am not selected for a scholarship. If I am selected to receive a scholarship, I will not actually receive any funds from the LBCC SBDC; my class fee will be reduced by the amount of scholarship available and I agree to pay the difference. If I am selected to receive a scholarship, I agree to write a letter of gratitude to the originator(s) of the scholarship funds.
By electronically signing this form I attest that all information I have provided is factual to the best of my knowledge.
Signature
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