ScaleUp Success Accelerator Program
Blue Wave Intake Form
Please take a few moments to answer the questions below. Your responses will help our team assess your company's current position and determine program participation eligibility. Thank you.
Contact Information
Your Name:
*
Phone Number
*
Please enter a valid phone number.
Business Name
*
Email Address:
*
What is your website address?
*
Type "None" if you do not have a website.
What's your business size?
*
Please Select
0 - 10 Employees
10 - 20 Employees
20 - 30 Employees
50 - 75 Employees
100 or more Employees
EIN
What goods and services do you provide?
*
Please Select
Arts/Crafts
Automotive
Accounting
Child Care
Cleaning Services
Clothing/Fashion
Communications
Computer Services
Construction
Gardening/Landscaping
Health Care
Insurance
Painting
Personal Care
Professional Services
Restaurant/Catering
Technical Services
Other
Date your company was registered
*
-
Month
-
Day
Year
Date
Number of Full Time Employees
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Number of Part Time Employees
*
Capability Statement?
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Yes
No
Certifications
*
HUBZone
WOSB
8(a)
Rural
SBE
None
Veteran
Economically Disadvantaged
Underserved
MBE
What type of technical assistance does your business need? Select all that apply.
*
Accounting and Financial Projections
Business Management Training
Certifications (Industry Specific or MWBEs...)
Credit Repair
Customer Discovery
Legal and Insurance
Licenses and Permits
Marketing and Sales
Mentoring & Networking
Product Development
Talent and Human Resources
Website Development
Business Plan Writing & Development
Does your business have W-2 employees?
*
Yes
No
Did you register in a state or local contracting system?
*
Yes
No
2023 Revenue
*
Covid-19 Economic Impact
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?
*
Yes
No
Did you temporarily close your business due to Covid-19 mandates?
Yes
No
Has your business received funds to help mitigate the impacts of COVID-19?
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Yes
No
If yes, what type of Covid-19 assistance did you receive? (PPP, EIDL, Federal Grant, State Grant)
*
Demonstrations of Financial Hardship. I declare by checking one or more of the boxes below that under penalty of perjury all of the foregoing demonstrations of financial hardship are true and correct.
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My business was shutdown due to COVID-19 state mandates.
My business has or had limited seating capacity due to COVID-19 state mandates.
My business had a decline in gross receipts or profits (annually or in any one quarter).
My business has had an increase in expenses due to COVID-19 (PPE, barriers or partitions, enhanced cleaning, outdoor space upgrades, etc).
My business has or had staffing difficulties/shortages.
My business has less capacity to weather financial hardship.
My business has faced increased startup costs due to the pandemic.
My business has lost expected startup capital due to the pandemic.
My business has faced challenges covering payroll and costs to retain employees.
My business needs assistance with the maintenance of existing equipment and facilities such as rent, leases, mortgages, utilities or other operating costs.
My startup has experienced challenges in raising capital including securing business loans.
General Management
Are you happy with the current performance of your business?
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Yes
No
Not Sure
Do you have detailed goals outlined for your business?
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Yes
No
Not Sure
Does your business have a strategic plan?
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Yes
No
Not Sure
Does your business have a business plan?
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Yes
No
Not Sure
Does your business have a vision and/or mission statement?
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Yes
No
Not Sure
Human Resources
Do you know your key employees strengths and weaknesses?
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Yes
No
Not Sure
Do you have detail job descriptions for most or all positions?
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Yes
No
Not Sure
Do you know how to classify your employees for tax related purposes?
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Yes
No
Not Sure
Do you have a procedure in place for onboarding new employees?
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Yes
No
Not Sure
Do you have an evaluation method for your employees?
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Yes
No
Not Sure
Are your employees properly trained to performed their duties?
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Yes
No
Not Sure
Marketing
Do you have a marketing plan in place for you business?
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Yes
No
Not Sure
Do you market your business online?
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Yes
No
Not Sure
Does your business have a unique brand, logo and/or tagline?
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Yes
No
Not Sure
Do you set specific goals for each promotional campaign or advertisement?
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Yes
No
Not Sure
Are your marketing and promotional efforts bringing in new customers/business?
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Yes
No
Not Sure
Do you regularly measure the results of your marketing and promotions efforts?
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Yes
No
Not Sure
Sales
What is your target market for sales/contracts?
Type "Not Sure" if you do not have a target.
Are you consistently hitting your sales targets?
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Yes
No
Not Sure
Are you satisfied with your current business's distribution channels?
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Yes
No
Not Sure
Are you attracting enough of your ideal customers?
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Yes
No
Not Sure
Are you generating enough qualified leads?
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Yes
No
Not Sure
Do you set measurable goals for your sales team?
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Yes
No
Not Sure
Finance
Are you achieving your financial goals for the company?
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Yes
No
Not Sure
Has your revenue grown steadily for the past three years?
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Yes
No
Not Sure
Is your cash position better than it was a year ago?
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Yes
No
Not Sure
Do you regularly monitor your cash flow?
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Yes
No
Not Sure
Do you track actual expenses so you know why profits are up or down?
*
Yes
No
Not Sure
Operations
Do you currently have established and/or document goals, strategies and company objectives to run your company?
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Yes
No
Not Sure
Do you have documentation, process maps or operations manuals describing your business operations in detail?
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Yes
No
Not Sure
Does everyone in your business understand which operational activities have the greatest impact on your business goals and profits?
*
Yes
No
Not Sure
Do you have a business in place to monitor and control your products/job costs?
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Yes
No
Not Sure
Are your products or services always delivered on time?
*
Yes
No
Not Sure
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