Application for Community Carrot Entrepreneurship Program

Application for Community Carrot

Please fill out the application form carefully. Filling out this form takes about 20 minutes. Please make sure you have the time to fill it out completely.
Full Name

First NameLast Name
Birth Date

MonthDayYear
E-mail
example@example.com
Phone Number
I am usually able to send and receive text messages

YesNo
I prefer that you contact me

by text messageby email
The best address for me is:

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Who should we contact if we can’t find you? (Name, relationship to you, preferred contact details): blanks
Education Background

List your previous schools, beginning with the most recent
I completed a GED

YesNo
High School
Graduated

YesNo
Any community college or college (it's fine if you didn't go, or didn't graduate)
Graduated

YesNo
Will you be in school of any kind, from November 2024 through March 2025?

YesNo
If you are currently working, please tell us where and what you do:
If you work, about how many hours a week?
About how much money did you make in the last year?
Did you or your family face financial challenges while you were growing up that caused difficulty affording basic needs like housing, food, or healthcare? Please explain. (Your answers are confidential. We ask because some of our funders want to know generally about the background of our participants with regard to financial stability.)
Following is a list of household income levels matched with the number of people in the household.

Thinking about where you grew up, did you grow up in housing that had "More," "Less," or "About the same" amount of money as listed for the size of your household?

1 person:$30,000; 5 people: $70,000

2 people: $40,000; 6 people: $80,000

3 people: $50,000; 7 people: $90,000

4 people: $60,000; 8 people: $100,000
For example, if 3 people lived in your house growing up and you think your family earned more than $50,000, you would write "MORE" below.

MoreLessAbout the same
What challenges and successes do you have with money? (We ask this question to help us prepare for serving our participants with information helpful to their needs.)
How do you describe your identity? You may check more than one box. Community Carrot does not discriminate nor make decisions based on race. We track this information because our funders want a broad picture of who we serve.

AsianAfrican AmericanAfricanHispanicLatinoPacific IslanderCaucasianNative AmericanOther
Do you have ideas for a business? It’s okay if you don’t. But if you do, what business are you thinking of starting or have already started?

Are there days of the week and times that you are not available to meet for our entrepreneurship instruction? We have one class that lasts 3 hours per week, and this will help us create a schedule that works with as many people as possible.

	Monday	Tuesday	Wednesday	Thursday
8am
9am
10am
11am
Noon
1pm
2pm
3pm
4pm
5pm
6pm
7pm
8pm
9pm

Is there anything else you'd like to tell us about your availability? For example, if you have a child that would need childcare, or if you absolutely can never meet on Wednesdays, please let us know below.
To take this program, you will need a good working laptop and wifi service. If you don't have regular access to one of these let us know and we will try to provide it for you.

I do not have a working laptopI do not have regular access to wifiI do not have a good working cell phoneI need help paying for my wifi serviceI need help paying for my cell phone

	1	2	3	4
I enjoy competition in work and play.
I often set goals for myself and meet them.
I’m good at motivating myself. Nobody has to get me going.
I like being responsible for myself and making my own decisions.
I enjoy seeking out new challenges.
No matter what I do, things are not really going to change for me.
I’m comfortable taking risks.
In group situations, I often take a leadership role.
I welcome opportunities to adapt, improve and grow.
I’m not the type to put things off when they need doing.
I have an open mind. I consistently challenge my own thinking.
Other people usually cause me to feel the way I do. I'd be more centered if it weren't for them.
I inspire enthusiasm and commitment in other people.
I’m a naturally curious person who enjoys learning new things.
I believe I have something valuable to offer the world.
I wake up early, feeling alert.
I know how to cope with uncertainty and stress.
Conversations with friends are often about how hard my life is.
I don’t get discouraged easily. Challenges motivate me to try harder.
I can accept and learn from constructive criticism.
I often identify new skills I need and work at acquiring them.
I usually find a way to make things right when they go wrong.
I’m willing to work hard to achieve goals that mean a lot to me.
I see opportunities where other people see threats.
I have a strong sense of personal ethics.
I can make up my mind in a hurry if I have to. These decisions usually turn out well.
People tell me I’m a good communicator.
I believe in being fair, so I aim for win-win situations whenever I can.

Application for Community Carrot

Education Background