2022 FFBA Cohort Application
Please complete the form below to apply to the FFBA program.
Name
*
First Name
Last Name
Business Name
*
Business Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Email Address
*
example@example.com
Phone Number
*
In what New York County is this business based?
*
Please Select
Albany County
Allegany County
Bronx County
Broome County
Cattaraugus County
Cayuga County
Chautauqua County
Chemung County
Chenango County
Clinton County
Columbia County
Cortland County
Delaware County
Dutchess County
Erie County
Essex County
Franklin County
Fulton County
Genesee County
Greene County
Hamilton County
Herkimer County
Jefferson County
Kings County (Brooklyn)
Lewis County
Livingston County
Madison County
Monroe County
Montgomery County
Nassau County
New York County (Manhattan)
Niagara County
Oneida County
Onondaga County
Ontario County
Orange County
Orleans County
Oswego County
Otsego County
Putnam County
Queens County
Rensselaer County
Richmond County (Staten Island)
Rockland County
Saint Lawrence County
Saratoga County
Schenectady County
Schoharie County
Schuyler County
Seneca County
Steuben County
Suffolk County
Sullivan County
Tioga County
Tompkins County
Ulster County
Warren County
Washington County
Wayne County
Westchester County
Wyoming County
Yates County
What is your role in the business?
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Owner/Operator
Partner
Executive Director
Manager
Staff
Other
Briefly list the products and/or services this business offers.
*
At what stage of development is this business?
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Idea stage
Startup (committed to a business plan/actively seeking funds)
Established (looking to grow/diversify)
Mature
Other
How many years has this business been in operation?
*
What is the business's current legal structure? (sole proprietorship, partnership, LLC, cooperative, etc.)
*
Does this business have additional employees, partners, or stakeholders? If so, please indicate how many and their role in the business, including full time, part time, seasonal, etc.
*
Does this business currently carry comprehensive business liability insurance?
*
What licenses, permits, or certifications do you have or plan to acquire for the business? (ex. NY Grown and Certified, Certified Organic, food processor, milk dealer, etc.)
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Please indicate the approximate volume of product you move per week/month/season as appropriate. (# of cwt of milk, # of animals, lbs of produce, etc.)
*
How many retail or wholesale outlets is this business currently providing products to? Briefly describe them.
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What is the business's most recent annual sales revenue?
Have you received funding or other support for this business from other government programs? If so, please describe agencies and roles of support. (funding, technical assistance, etc.)
Please rank the following FFBA services in order of importance to you (click and drag blocks to re-order):
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Networking + Collaboration
Participation in this program will include peer-to-peer collaboration and networking. There will be opportunities for cohort members to get to know one another and share their successes and challenges.
What type of networking/collaboration do you feel would be most valuable to you?
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New Value-Added Product
Please refer to the attached documents outlining the USDA definition of value-added products as you respond to the following questions.
What is the new value-added product you are interested in producing? Please provide a brief description.
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Do you produce/own 100% of the inputs used to create this value-added product? If not, what percent of the inputs do you produce/own?
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Please describe the stage of development this product is currently at.
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Please describe the resources (services, facilities, consultation, equipment, etc.) necessary for the business to bring this value-added product to market and grow your business.
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Please describe your level of experience with developing this type of value-added product.
What is, or what do you expect to be, the biggest challenge in producing this product and bringing it to market?
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Have you previously attempted to bring this product, or a similar one, to market? If so, what prevented you from being successful?
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What is your ethnicity/cultural heritage?
Black/African American/Afro-Caribbean/African
Latinx/Chicanx/Hispanic
Indigenous/Original People
Asian descent
Native Hawaiian/Pacific Islander
White/European descent
Prefer not to answer
Other
What is your gender?
Female
Male
Nonbinary
Trans
Prefer not to answer
Other
Do you self identify or have certification that you are:
Minority or Women-owned Business Enterprise (MWBE)
Veteran
Black, Indigenous, and People of Color (BIPOC) Owned
LGBTQ+ owned
Other
How did you hear about the FFBA program?
Submit
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