2024 Scale Up Success Accelerator Interest Form

Scale Up Interest Form

2024 SPANISH COHORT

Please review the basic eligibility criteria and program schedule before submitting.

Click here for Program Schedule.
- Participant must be the business owner, partner, or manager within the organization.
- Business must have been economically impacted by the COVID-19 pandemic.
- Business must be in Dallas County.
Thank you for your interest in the ScaleUp Success Accelerator Program.

Before proceeding with the form, please ensure that you have thoroughly reviewed the program's requirements and are able to meet them.

We prioritize program success and consider only those who can commit to the requirements and schedule.

We kindly request that you visit the program's website Scale Up Success Accelerator, and review the requirements carefully.

If you have any additional questions, please contact the Program Director, Paola Rosas, at Paola@gdhcc.com or the Program Coordinator, Lissette Martinez, at lissette@gdhcc.com.

Thank you!
Prior to proceeding with the interest form, would you kindly confirm that you have had the opportunity to review the program requirements and schedule?*

YesNo
Your commitment to attend 10 weekly business workshops, as well as any additional training or counseling sessions is required. Can you confirm that you're available to meet the program's schedule and fulfill its requirements?*

Yes, I commit to the program's requirements.No, I can't commit right now.
Full Name *

First NameLast Name
Phone Number*
Please enter a valid phone number.
Email*
example@example.com
Home Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Race*
Gender
How did you learn about Scale Up Success Accelerator?*
ABOUT YOUR BUSINESS

Please enter your business information. All fields are required.
Is or will your business be located in Dallas County?*

YesNo
Business Name*
Phone Number*
Please enter a valid phone number.
Business Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Date Company Established*

MonthDayYear
Date
Is your business home based?*

YesNo
Website*
Type NONE if you do not have a website
% of Business Owned: *
What goods or services do you provide?*
Number of full-time employees (count yourself as one if you do not have employees)*
Number of part-time employees:*
If currently in business, what were your total sales (revenue) last year?*
Has your business experienced financial hardship due to the COVID-19 pandemic either with loss of revenue, market instability, closures, increases in expenses, labor shortages or other?*

YesNo
Has your business received funds to help mitigate the impacts of COVID-19?*

YesNo
If you answered YES to the previous question, please select the type of Covid-19 Assistance you received. – check all that apply:*

PPPEIDLFederal FundingState FundingCounty FundingCity FundingGrantsSubsidized LoansOther Financial Assistance
Are you looking for financial assistance, such as a loan, to start or grow your business?*

YesNo
How would you describe your credit history?*
Small Business Certifications – check all that apply:*

VeteranHubZoneEconomically DisadvantagedSBEWOSB CertificationRuralUnderservedMBE8(a)None
Signature*

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ABOUT YOUR BUSINESS