Entrepreneur Tech Program Intake Form

Name*

First NameLast Name

Email*

example@example.com

Phone Number*

Please enter a valid phone number.

Business Name*

Business Description (3-4 sentences)*

Business Website (if applicable)

Is your business a legal entity? (i.e. LLC, LLP, etc)*

YesNo

If yes, what state is your business registered in?

Mindset & Resilience*

	Not Met	Somewhat Met	Fully Met
Defined business vision and purpose
Awareness of unique challenges for entrepreneurs
Resilience and adaptability skills

Market Research & Opportunity Identification*

	Not Met	Somewhat Met	Fully Met
Knowledge of market analysis and niche identification
Skills in customer surveying and demand assessment
Ability to create a unique value proposition

Goal Setting & Strategic Planning*

	Not Met	Somewhat Met	Fully Met
Experience with short- and long-term goal setting
Business model creation and strategic planning
Adaptability in revising goals and strategies

Other entrepreneurial foundation topics where you need assistance.

Brand Identity*

	Not Met	Somewhat Met	Fully Met
Defined brand mission, vision, and values
Development of brand assets (logo, color palette)
Consistency in brand image and customer expectations

Digital Marketing & Content Creation*

	Not Met	Somewhat Met	Fully Met
Familiarity with social media, website, and email marketing
Skills in storytelling and content creation
SEO knowledge and lead generation

Customer Engagement*

	Not Met	Somewhat Met	Fully Met
Techniques to build customer loyalty and brand ambassadors
Knowledge of influencer marketing and partnerships

Marketing Analytics*

	Not Met	Somewhat Met	Fully Met
Skills in tracking KPIs and using analytics tools
Setting data-driven marketing goals
Using customer feedback to refine strategies

Other branding and marketing topics where you need assistance.

Financial Management*

	Not Met	Somewhat Met	Fully Met
Understanding profit/loss, balance sheets, and cash flow
Budgeting and expense management skills

Funding Knowledge*

	Not Met	Somewhat Met	Fully Met
Awareness of grants, loans, and investor funding
Credit management and funding readiness

Financial Statement Analysis*

	Not Met	Somewhat Met	Fully Met
Interpreting Balance Sheets: assets, liabilities
Interpreting Income Statements: revenue, expenses
Analyzing Cash Flow Statements: cash inflows and outflows

Informed Decision Making*

	Not Met	Somewhat Met	Fully Met
Using financial data for strategic investments and pricing
Assessing marketing and operational efficiency based on data

Cash Flow Management*

	Not Met	Somewhat Met	Fully Met
Understanding revenue versus actual cash flow
Ensuring business liquidity for meeting obligations

Expense Tracking*

	Not Met	Somewhat Met	Fully Met
Tracking all business expenses accurately
Identifying potential areas for cost-cutting

Budgeting*

	Not Met	Somewhat Met	Fully Met
Creating and adhering to a budget
Planning future expenses and investments effectively

Accounting Methods*

	Not Met	Somewhat Met	Fully Met
Choosing between cash and accrual accounting for accurate financial reflection

Tax Implications*

	Not Met	Somewhat Met	Fully Met
Understanding tax obligations for the business structure
Ensuring timely and accurate tax filings

Financial Forecasting*

	Not Met	Somewhat Met	Fully Met
Creating financial projections for future revenue and expenses
Using forecasts for decision-making and funding

Debt Management*

	Not Met	Somewhat Met	Fully Met
Understanding loan terms and managing debt levels
Maintaining financial stability while utilizing debt effectively

Raising Capital*

	Not Met	Somewhat Met	Fully Met
Ensuring strong financial literacy to secure investor funding
Demonstrating financial viability and growth potential to investors

Business Planning for Investors*

	Not Met	Somewhat Met	Fully Met
Creating financial projections
Structuring financials for investor presentations
Basic knowledge of valuation

Investor Pitching Skills*

	Not Met	Somewhat Met	Fully Met
Compelling pitch creation
Pitch deck development
Investor Q&A preparation

Other financial and funding topics where you need assistance.

Business Systems & Automation*

	Not Met	Somewhat Met	Fully Met
Knowledge of CRM, project management, and accounting tools
Current use of automation to increase efficiency
Evaluating and selecting systems that align with your business needs

CRM (Customer Relationship Management)*

	Not Met	Somewhat Met	Fully Met
CRM setup and customer service enhancement
Lead management and sales pipeline organization

Project Management*

	Not Met	Somewhat Met	Fully Met
Planning, delegation, and project tracking skills
Familiarity with project management tools (Asana, Trello, etc.)
Creating efficient workflows

Technology Integration*

	Not Met	Somewhat Met	Fully Met
System integration (CRM, project management, marketing)
Cybersecurity basics for small business

Other systems, processes and technology topics where you need assistance.

Emotional Intelligence*

	Not Met	Somewhat Met	Fully Met
Self-awareness and regulation skills
Empathy and active listening skills
Techniques for EI development

Leadership & Conflict Management*

	Not Met	Somewhat Met	Fully Met
Goal-setting and team motivation abilities
Conflict resolution skills

Mental Health & Well-Being*

	Not Met	Somewhat Met	Fully Met
Stress management techniques
Building support networks
Work-life balance skills

Other emotional intelligence and leadership topic where you need assistance.

Growth Readiness*

	Not Met	Somewhat Met	Fully Met
Identifying scalability indicators
Developing scalable processes and hiring plans
Managing culture and brand integrity

Partnerships & Networking*

	Not Met	Somewhat Met	Fully Met
Networking strategies, both online and in person
Leveraging industry connections

Other scaling and growth topic where you need assistance.

Hiring and Recruitment*

	Not Met	Somewhat Met	Fully Met
Recruitment process understanding
Crafting job roles and descriptions

Employee Onboarding & Retention*

	Not Met	Somewhat Met	Fully Met
Developing an onboarding process
Engagement and retention strategies
Performance management and feedback handling

Legal Compliance and Benefits*

	Not Met	Somewhat Met	Fully Met
Basic employment law knowledge
Planning employee benefits
Policies and workplace safety

Other HR topic where you need assistance.

Real Estate Acquisition

	Not Met	Somewhat Met	Fully Met
Identifying suitable properties
Zoning, permit knowledge
Lease vs. buy considerations

Property Management

	Not Met	Somewhat Met	Fully Met
Basics of property management
Maintenance, tenant relations
Setting rental terms

Legal and Financial Aspects

	Not Met	Somewhat Met	Fully Met
Real estate taxes and deductions
Legal contracts and agreements
Property financing options

Other real estate topic where you need assistance.

Entrepreneur Tech Program Intake Form

Entrepreneurial Foundations

Branding and Marketing Essentials

Financial Acumen and Funding

Systems, Processes, and Technology

Emotional Intelligence and Leadership

Scaling and Growth

Human Resources

Real Estate (If Applicable)