SBMI Application Form

1
Are you located in the United States?* This field is required.
YESNO
2
First Name
3
Last Name
4
Email Address
5
Phone Number
Area Code
Phone Number
6
How are you interested in partnering?* This field is required.
I'm a business leader interested in serving as a mentor.
I'm a business owner looking for mentorship.
7
Name of Employer
8
Current Position
9
Please list all the industries where you have experience:
10
For the following five questions, please check off the areas you are comfortable mentoring and advising entrepreneurs on. If you are not comfortable in one area, simply click "skip."
11
Accounting & FinanceIf none of these areas apply to you, click "ok" to continue to the next group of areas...
Business Accounting / Budgeting
Cash Flow Management
Finance/Valuation
Tax Planning
Skip
12
Sales & Marketing
Customer Acquisition / Relations
Market Research / Competitive Analysis
Consumer Software
E-commerce
Skip
13
Operations & Execution
Technology & Computers
Product Supply
Crises Management/Recovery
Human Capital Management
Skip
14
Legal & Governance
Incorporation
Crises Litigation
Government Contracting
International Trade
Skip
15
Leadership & Management
Business Strategy
Communication
Conflict Management
High-Performing Teams
Skip
16
SBMI works in partnership to provide Mentors for two other organizations, IFEL and ICIC. The following questions are designed to understand your interest/possible fit with their programs:
17
Would you have an interest in helping with Capital Raising (not a requirement)?
YESNO
18
Are you interested in being on a ‘Skilled Resources’ List to help other Entrepreneurs (besides the one you are assigned to Mentor) on a more limited basis?
YESNO
19
What else would be helpful for us to know in order to match you with a small business owner?
20
Name of Company
21
Industry
22
What was your revenue in the last 12 months?Choose the range that best represents the total number of dollars your business brought in during the last 12 months.
$0-5,000
$5,000-$50,000
$50,000-$100,000
$100,000-$250,000
$250,000+
23
How long have you been in business?
Less than 6 months
6–12 months
12–24 months
24+ months
24
Where is your business located?City and state, please.
25
For the following five questions, please check off the areas you would like help from mentoring. If you do not need help in a given area, simply click "skip."
26
Accounting & Finance
Business Accounting / Budgeting
Cash Flow Management
Finance/Valuation
Tax Planning
Skip
27
Sales & Marketing
Customer Acquisition / Relations
Market Research / Competitive Analysis
Consumer Software
E-commerce
Skip
28
Operations & Execution
Technology & Computers
Product Supply
Crises Management/Recovery
Human Capital Management
Skip
29
Legal & Governance
Incorporation
Crises Litigation
Government Contracting
International Trade
Skip
30
Leadership & Management
Business Strategy
Communication
Conflict Management
High-Performing Teams
Skip
31
Are there any other topics not listed above that are a priority for you to receive Mentoring help?
32
What else would be helpful for us to know in order to match you with a Mentor?
33
Thank you! We are reviewing your application and will reach out soon.
Should be Empty:

For the following five questions, please check off the areas you are comfortable mentoring and advising entrepreneurs on. If you are not comfortable in one area, simply click "skip."

SBMI works in partnership to provide Mentors for two other organizations, IFEL and ICIC. The following questions are designed to understand your interest/possible fit with their programs:

For the following five questions, please check off the areas you would like help from mentoring. If you do not need help in a given area, simply click "skip."

Thank you! We are reviewing your application and will reach out soon.