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Format: (000) 000-0000.
- Date of Birth*
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- Completion Date
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- Currently enrolled in another incubator or accelerator program receiving funding for this same business?*
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- Current stage of your business*
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- Does your business serve an under-resourced community?*
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- I am willing to participate in monthly mentor check-ins for a minimum of 6 months.*
- I am willing to submit progress reports at 90 days, 6 months, and 12 months as a condition of the award.*
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- Date*
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- Should be Empty: