Amp Up Charlotte Application Form

This application will take approximately 20 minutes to complete. Once you begin the application, you must complete all required fields; partially completed applications cannot be saved or submitted.

Applicant Name*

First NameMiddle NameLast Name

Business Name*

Business Address*

Street Address

Street Address Line 2

CityState

Postal / Zip Code

Business Phone*

Area CodePhone Number

Cell Phone*

Area CodePhone Number

Email Address*

Website*

Industry*

Referred by*

Please provide a brief description of your business:*

What month and year did you start/buy your business?*

YesNoOther

Number of full-time employees: *

Number of part-time employees: *

Estimated annual revenue from last calendar year: *

Where do you hope to see your business in three years?*

How do you plan to make time to participate in the program? *

Have you participated in a coaching or business growth program before? If so, please list them. *

What is the biggest challenge your business is facing right now?*

Do you have support staff or systems in place that allow you to step away for training without harming your operations? Please explain.*

Why do you want to participate in AMP Up Charlotte at this stage of your business journey?*

This free program, valued at $15,000 is being provided for you by the City of Charlotte so that you can grow and sustain your business.

Ineligible businesses include: non-profit organizations, liquor stores, check cashing establishments, weapons shops, pawn shops, smoke or vape shops, gambling establishments, adult-entertainment-related businesses, and stores that sell non-FDA approved pharmaceuticals.

Questions? Contact: Anika Ellis, anika.ellis@charlottenc.gov

AMP UP Charlotte Application