Business Planning for Entrepreneurial Success Expression of Interest Form

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Pour recevoir information ou un soutien en français, veuillez contacter Federation de gens d’affaires francophones de l’Ontario (FGA), au 647-510-3445 ou info@fedefranco.ca.

Name*

First NameLast Name

Your Business Name or Proposed Business Name

Phone Number*

E-mail*

example@example.com

Website or primary social media page if you have one

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

If your business is currently operating, when did you start operating?
blanks Month blank Year

If your business is already registered, when did you register?
blanks Month blank Year

If known, please indicate the structure of your business:

Sole ProprietorshipPartnershipCorporationNot sure or not yet registered

If you are already operating, how many people are currently employed by the business (including yourself as owner/operator)? Use 0.5 to count any part time staff.

Briefly describe your business or business idea.*

What aspects of building a business are you looking to most improve your knowledge and skills in through this course? *

Have you registered with the Business Enterprise Centre before?*

Yes, for this businessYes, for another businessNo, this is my first visit

Where did you hear about the Business Enterprise Centre?*

What are your plans for your business?*

Do you or your business have a Lambton County address?*

YesNo

Have you received a Starter Company Plus or Summer Company grant in the past?*

Yes, Summer CompanyYes, Starter Company PlusNeitherI don't know what these are

Do you self-identify as one of the following groups? If yes, select all that apply.

Francophone2SLGBTQ+Youth under 30 years of ageNewcomers to Canada (landed immigrants who came to Canada up to 5 years prior to a given census year)I prefer not to answer

Do you self-identify as a person with one or more disabilities?

YesNoI do not knowI prefer not to answer

Do you self-identify as First Nations, Métis, and/or Inuit? If yes, select all that apply.

Yes, First NationsYes, MétisYes, InuitI prefer not to answer

Do you self-identify as part of any of the following groups? If yes, select all that apply.

Do you self-identify as:

The Sarnia-Lambton Economic Partnership (SLEP) and associated Business Enterprise Centre (BEC) (or Small Business Enterprise Centre (SBEC)) recognizes the importance of the privacy and protection of clients' personal information. Personal information may be required in connection with purchases, service requests, event registrations and program applications. The information you provide will not be used except as reasonably required to provide our services.

Any information you provide that is not publicly available will be treated as confidential.

We only collect, retain and use personal information where it is essential for the following purposes:

Process your requests for services, products or further information
Communicate with you regarding services or products you have requested
Identify you if you have a question or concern about a service or product you have requested
Advise you about changes to our service offerings and of service interruptions
Meet legal and regulatory requirements
Meet requirements of our County and Provincial government funding partners

Your business profile will be disclosed to supporting Starter Company PLUS program delivery (i.e. training) partners. It will also be disclosed the Ministry of Economic Development, Job Creation and Trade and the Government of Ontario to verify service delivery of the BEC and collect feedback by requesting clients participate in a voluntary survey regarding programs and services received through our organization.

For more information about this collection, please contact:
Ministry of Economic Development, Job Creation and Trade
Business Partnerships and Programs Division
Talent and Entrepreneurship Branch
2 Queen Street East, 3rd Floor
Toronto, ON M5C 3G7

I understand and provide consent to the Sarnia-Lambton Economic Partnership and associated Business Enterprise Centre to maintain records of my personal or business information and share as required with regulatory and/or government funding bodies and any associated program delivery and (i.e. training) partners:*

YesNo

I understand that I am solely responsible for the planning, implementation, financing, operation, success and development of my business. Any advice or suggestions made are for my consideration and I am not bound to take any such advice or suggestions and can obtain advice and assistance from any source, but ultimately any decisions pertaining to my business is my responsibility. I release the representatives from the Sarnia-Lambton Economic Partnership and the Business Enterprise Centre from any claim for loss or damages suffered by me or my business, in connection with the counselling or consultation provided:*

YesNo

Signature*

Business Planning for Entrepreneurial Success - Course Registration Request

Starter Company PLUS Grant

Course Eligibility Requirements

Additional VOLUNTARY Disclosure Information

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