Minority Small Business Program
AWARD APPLICATION
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ELIGIBILITY CRITERIA
All conditions below have to be met in order to be eligible to submit this application
Have you attended and/or listened to the orientation session?
*
Yes
No
Date attended orientation session or received recorded session from SCORE
*
-
Month
-
Day
Year
Date
Note email used for orientation registration if different from email on the application
Is Your Business Registered In or Have a Businesses License in South Carolina?
*
Yes
No
Is Your Business 51% Owned by African American, Hispanic, Asian, or Native American?
*
Yes
No
Does Your Business Have 25 or Fewer Employees?
*
Yes
No
Is Your Business Located in Beaufort, Jasper, Colleton, or Hampton Counties?
*
Yes
No
If the answer is No to any of the questions above, the application will not continue.
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APPLICANT’S INFORMATION:
Date
*
-
Month
-
Day
Year
Date
Full / Legal Name
*
First Name
Last Name
Home Address
*
Street Address
Street Address Line 2
City
Please Select
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
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Business Name
*
Please Note: Only one application per business may be submitted
Business Address (if different from Home Address)
Street Address
Street Address Line 2
City
Please Select
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
County
*
Beaufort
Jasper
Colleton
Hampton
Phone Number
*
-
Area Code
Phone Number
E-mail
*
Website URL
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How long have you been in business?
*
Start up < 1 yr old
Start up 1-2 yrs old
Existing Business 3-5 yrs old
Existing Business >5 yrs old
Please describe your business. Include the type of business and the product/services you offer. Example: My business serves the Jasper county and surrounding areas by providing home health care to clients who have limited mobility. We provide personal care and therapy services that aid client recovery.
*
(300 words or less)
0/300
Do you have a business plan for your company? (If yes, please include a copy of your plan. If no, please attach Simplified Business Plan and Profit & Loss as provided in the orientation session.)
*
Yes
No
Upload Your Company's Business Plan or Summary of Operations
*
Upload File from Your Computer
Please use a Microsoft Document or Adobe PDF
Cancel
of
Upload Your Company's Financials
*
Upload File from Your Computer
Please use Microsoft Excel or Adobe PDF
Cancel
of
Please describe why you chose this business?
*
(300 words or less)
0/300
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Do you expect your business to hire any employees in 2022 or 2023? If yes, please state how many you expect to hire?
*
0
1
2
3
4
5+
Amount of request?
*
Please note maximum award is $2,500
Give us a summary of your request. Make sure your summary includes a description for how the award money will help your business succeed.
*
(300 words or less)
0/300
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Tell us what amount of the award you requested will be used for the purposes listed below:
*
Percentage of Grant Requested ($)
Personnel/Staff
Professional fees (legal, accounting, CPA services)
Marketing materials
Website
Equipment
Other
What is the total cost of the area(s) you selected above?
*
Amount of Award Requested ($)
*
If there is a difference between the amount requested and the total amount needed, what main source(s) will make up the difference? Include dollar amount, name of source, and “Committed” or “Pending”.
(300 words or less)
0/300
Is there any other information that you want to share with us?
(300 words or less)
0/300
Have you received any other grants or awards from any organization within the last 12 months?
*
Yes
No
If yes, how much and from whom?
(300 words or less)
0/300
Please tell us how you heard about our program?
*
Facebook
Instagram
LinkedIn
SCORE Mentor
SCORE Website
Email
Word of Mouth
Flyer
Radio
Television
Other
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APPLICANT’S DEMOGRAPHIC INFORMATION:
Ethnicity Race
*
Black/African American
Hispanic/Latino
Asian
Native American
Age Group
*
18-24
25-45
45-65
Over 65
Do Not Wish to Respond
Military/Veteran Status
*
Active Military
Retired Military/Veteran
Non-Military
Do Not Wish to Respond
Persons with Disabilities (PWD)
*
PWD
Non-PWD
Do Not Wish to Respond
Gender
*
Male
Female
Do Not Wish to Respond
*
I have read and agree to abide by the award rules.
Type your name here.
*
This action constitutes your signature on this application as well as a signature and acceptance for the terms and conditions as published on the SCORE SC Lowcountry website.
All submissions are final, no changes are allowed.
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