BUSINESS IN A BAG INTAKE FORM

Business In A Bag Intake Form

Business Details
Business Name
Business Start Date

Date business started Fiscal year end date (ex: 12/31)
Social Media Handles

Website or social media handleWebsite or social media handle
Business Location (if different from Home address)

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Copy of ID/Drivers License

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Business In A Bag Intake Form

Business Information
What products/services do you offer?

Other
Do you have an EIN Number? If so, please provide.

Other
Additional information (please give us any information that can help us understand your business/issue/concerns)

Business In A Bag Intake Form

Submit my Application
The information provided in this application shall not be shared to anyone else and is kept confidential
INFORMATION SHARING: In order to provide our services, we will need to obtain from you certain personal and business financial records. Our ability to assist you depends upon the accuracy and completeness of the information that you provide to us. We may request updated information on your business and personal financial circumstances at periodic intervals from your first engagement with Business In A Bag. You agree to provide us with all of the relevant personal and business financial information that we request, including information about your income, debts, credit, earnings, assets, taxes, social security number (only if necessary), and employment. To the extent that we have obtained access to your records for bookkeeping purposes, we may use this information to update your internal business financial records for impact assessment purposes. I agree that the information herein is true and correct, and I hereby authorize and/or expressly grant permission to Business In A Bag, it’s subsidiaries, partners and/ or faculty to complete, sign, and submit any and all necessary documentation, filings, tax returns, applications, forms, electronic and/or otherwise solely in the interest of your Business. By submitting this Agreement, you authorize us to share information concerning your finances and your business or business idea with our Partners, solely in connection with the provision of our services. Any such information that we obtain will be treated confidentially, including under applicable ethical rules governing an attorney’s obligations to maintain confidences. We and our Partners will not disclose any such information to anyone except: (i) Business In A Bag staff including, without limitation, employees, fellows, volunteers, interns, and externs for the performance of our service; (ii) our Partners; (iii) as otherwise authorized by you; or (iv) as required by law, court order, or regulatory authority. We and our Partners may compile data and information provided by you, but such information will only be disclosed on an aggregate or illustrative basis and will not be disclosed in a manner that would personally identify you. WAIVER AND RELEASE; You hereby unconditionally waive any right to institute any and all claims against Business In A Bag, Dr. Kyera Williams and/or our Partners and release us and/or our Partners from any liability arising from or in any way related to our services. There are NO refunds on ANY SERVICES or deposits. Please click the link below to see our privacy policy, disclaimers and terms and conditions. By clicking "Submit", you agree to all policies and disclaimers. https://form.jotform.com/242755909711160
Who referred you
Enter the person who referred you
What Results are you looking to obtain from purchasing this product/service?
Should be Empty:

Business In A Bag Intake Form

Business In A Bag Intake Form

Business In A Bag Intake Form

Business In A Bag Intake Form