Small Business STRONGER for Economic Mobility - Delaware Leadership Application Form

Small Business STRONGER for Economic Mobility Leadership Application
Offered by Delaware Black Chamber of Commerce

Thank you for considering our program and taking the time to complete the executive leadership application. We are excited to review your submission and learn more about how you can contribute to the economic mobility of your business and employees.

This application will take approximately 7 minutes to complete. Once you begin the application, you must complete all required fields; partially completed applications cannot be saved or submitted.
Applicant Name

First NameMiddle NameLast Name
Business Name
Business Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Business Phone

Area CodePhone Number
Cell Phone

Area CodePhone Number
Email Address
Website
Industry
How did you find out about the program? (Check all that apply)

Other
Race/Ethnicity:

Other
Are you Hispanic, Latino or Spanish origin?
Please provide a brief description of your business:
What month and year did you start/buy your business?
Are you the 100% owner?

Other
Number of full-time employees:
Number of part-time employees:
Number of contracted employees:
Estimated annual revenue from last calendar year:
How much funding have you received and how did it come in? (Check all that apply)

Other
Are you a graduate of a StreetWise MBA program?
If no, have you participated in any other small business capacity building programs? If so, please describe below.
Why do you want to be in this program?
In what ways have you improved the job quality and/or job satisfaction for your employees? Check all that apply:

Other
I agree to attend and participate in the in-person workshop and five virtual sessions:
Should you have any questions or require further information about the program or the application process, please do not hesitate to reach out to Ayanna Khan at email@debcc.org.
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Small Business STRONGER for Economic Mobility Leadership Application