ACCESS Business Lab Registration Form

The ACCESS Business Lab

Program Application Form
Your privacy is our priority. Information shared through this form will be used exclusively to assess your eligibility for and participation in ACCESS programs.

Please note that we can only accept applicants from Ontario.
1. Personal & Contact Information
First and Last Name*
Email Address*
Primary Phone Number*
Please enter a valid phone number.
Primary Phone Type*

HomeMobileOffice / WorkOther
Secondary Phone Number
Please enter a valid phone number.
Secondary Phone Type

HomeMobileOffice / WorkOther
Residential Address*
Age Range*
Gender*

MaleFemaleNon-BinaryPrefer not to say
Your Status in Canada*

Canadian Citizen (born here)Permanent ResidentCanadian Citizen (naturalized)Refugee ClaimantConvention Refugee / Protected PersonOther
Since you answered "Other" Status in Canada, please note specifics:*
Which of the following best describe your ethnic/cultural background? (Select all that apply)*

IndigenousBlack (e.g. African Descent)Latino (e.g. Latin American, Hispanic)Caribbean (e.g. Bajan, Jamaican, Dominican, etc)East Asian (e.g.. Chinese, Korean, Japanese, Taiwanese, etc)Southeast Asian (e.g. Indian, Pakistani, Sri Lankan, etc)Middle Eastern (e.g. Arab, Persian, Turkish, etc)Central Asian (e.g. Kazakh, Afghan, Uzbek, etc)White (European Descent)Multiracial/EthnicOtherPrefer not to say
Since you selected "Other" background, please specify:*
Your Level of Education*

No formal educationPrimary/Elementary SchoolSecondary/High SchoolCollegeUndergraduate DegreeGraduate
Your Employment Status*

UnemployedOn Government SupportPart-timeFull-timeSelf-employedOther
Since you selected "Other" employment status, please specify:*
Your Annual Income*

$0 - $9999$10,000 - $19,999$20,000 - $39,999$40,000 - $59,999$60,000 - $79,999$80,000 - $99,999$100,000 - $119,999$120,000 - $149,999$150,000 - $199,999$200,000 +Prefer not to say
Number of your dependents under 18*

012-34-56+
How did you hear about the ACCESS Business Lab program?*

ACCESS Staff MemberOther ACCESS Client/ParticipantOnline / Social MediaAgency Referral
Please specify Agency Name:*
Tell us your story.*
2. Business Idea and Experience

We strongly encourage applicants to prepare at least one business idea that they wish to develop through this program. This could be an existing or a new business idea.
Do you currenly have a business idea or run an existing operating business?*

YesNo
Thank you for your responses to this application.

Since we strongly encourage all applicants to have a business idea to work on in this program, please confirm that you'd like one of our ACCESS staff to contact you, to discuss your situation and eligibility for the program.
Would you like an ACCESS staff member to contact you to discuss your situation and eligibility for the Business Lab program?

Yes - please contact me to discuss.No - I will apply again once I have a business idea prepared.
Thank you. After you click Submit to register your responses, one of our ACCESS staff members will contact you by email within 5 business days.
What stage is your business idea or existing operating business at?*
(Optional) Please share your latest business plan documents for your business idea.

Cancelof
Please provide the Company Name and links to website(s) and social media for your operational business.*
(Optional) Please share company logo files, recent business plans, and other documentation from your operational business(es).

Cancelof
Have you ever previously owned and run a business OUTSIDE Canada?*

YesNo
Have you ever previously owned and run a business IN Canada?*

YesNo
Have you previously participated in a business training program in Canada?*

YesNo
Please provide the name of the training program/organization.*
Have you participated in any of our programs in the past?*

YesNo
Please provide the month/year when you participated.*
Have you previously received business or professional coaching or mentorship?*

YesNo
Please provide the name of the coaching/mentorship program/organization.*
Briefly tell us what you are hoping to gain from participation in the ACCESS Business Lab program.*
3. Program Attendance and Participation

To get the most out of the program, we strongly encourage commitment and attendance.
Overview:

The ACCESS Business Lab includes a series of 13 workshops over ~6 weeks (typically 2 per week, 2-3 hours each on weekday evenings) with optional coaching available either weekdays or weekends. Topics covered include:
- Business Ideation & Defining Your Vision;
- Developing & Validating Your Business Idea;
- Market Research & Analysis;
- Developing a Sales & Pricing Strategy;
- Low-Cost & Digital Marketing Strategies;
- Business Financials & Cash Flow;
- Business Taxes;
- Bookkeeping Fundamentals;
- Business Banking, Credit & Financing;
- Legal Requirements for Businesses;
- Design Thinking;
- Public Speaking, Pitching & Presentation Skills;
- Business Plan Pitch & Presentation Feedback
Do you plan to attend the full Workshop Series?

Yes, I plan to attend all sessions.No, I would only like to register for select topics.
Please select the workshop topics you wish to attend:

Business Ideation & Defining Your VisionDeveloping & Validating Your Business IdeaMarket Research and AnalysisDeveloping a Sales & Pricing StrategyLow-Cost & Digital Marketing StrategiesBusiness Financials & Cash FlowBusiness TaxesBookkeeping FundamentalsBusiness Banking, Credit & FinancingLegal Requirements for BusinessesDesign ThinkingPublic Speaking, Pitching & Presentation SkillsBusiness Plan Pitch & Feedback
Please select which topics you wish to attend for Group Coaching (if any):

Business Ideation & Defining Your VisionDeveloping & Validating Your Business IdeaMarket Research and AnalysisDeveloping a Sales & Pricing StrategyLow-Cost & Digital Marketing StrategiesBusiness Financials & Cash FlowBookkeeping FundamentalsLegal Requirements for BusinessesDesign ThinkingNone: No group coaching requested
Please select which topics you wish to request for One-to-One Coaching (if any):

Business Ideation & Defining Your VisionDeveloping & Validating Your Business IdeaMarket Research and AnalysisDeveloping a Sales & Pricing StrategyLow-Cost & Digital Marketing StrategiesBusiness Financials & Cash FlowBookkeeping FundamentalsLegal Requirements for BusinessesDesign ThinkingNone: No 1:1 coaching requested
Would you prefer to participate in the "women-only" version of this program?*
Note: The 'women-only' program option is subject to availability and demand. A minimum of 15 participants is required for the program to be offered.
Please specify any conflicting issues that might affect your ability to attend any workshop sessions and complete the program. (e.g., employment, school, childcare, time of session, lno computer/internet access, other (specify)

EmploymentSchoolChildcareNo Computer/Internet AccessTime of workshop series (evenings)Other
Please Specify any other potential issues that could affect your attendance.
4. Media Consent and Release

As part of the program, we often publish feature stories and profile our clients and their businesses. We would like your consent to share such stories about you and your business.
If you complete the ACCESS Business Lab program, would you be interested in being featured in our Marketplace, Newsletter and Social Media platforms?*

YesNoNot sure: please contact me to discuss.
Do you authorize ACCESS Community Capital Fund to use your images or video footage, in whole or in part, individually or in conjunction with other images and video footage, to be displayed on its website and other official channels, and to be used for media purposes including promotional presentations and marketing campaigns? You agree to waive rights to privacy and compensation, which you may have in connection with such use of your name and likeness, including rights to written copy that may be created in connection with video production, editing and promotion therewith. **

I agreeI do not agree
Today's Date*

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The ACCESS Business Lab

Your privacy is our priority. Information shared through this form will be used exclusively to assess your eligibility for and participation in ACCESS programs.

1. Personal & Contact Information

2. Business Idea and Experience

3. Program Attendance and Participation

4. Media Consent and Release