Women's Business Center Financial Aid and Scholarship Application

Women's Business Center Financial Aid and Scholarship Application
The Women’s Business Enterprise Center-East strives to make our services available to all entrepreneurs, regardless of economic background or current financial situation.

Use this form to let us know about any circumstances that make it difficult for you to access our services at the listed rates. The information you provide will help us determine the appropriate cost for you based on our sliding scale, or your scholarship eligibility (only for full Jumpstart series). This form must be completed before you register for a program or sign up for one-on-one business counseling.

When you click "submit," you and our office will receive a copy of the information you provide below. We will contact you with your approved rate and further instructions, or a scholarship decision and further instructions. If you have any questions or would like to discuss this form, please contact Allie Mullins at amullins@wbeceast.com.
Your Name*
Business Name (or business idea)*
Phone Number*
xxx-xxx-xxxx
Email*
example@example.com
Please select the program or service for which you are requesting a reduced rate.*
I am applying for:*

Financial Aid (sliding-scale cost)Full Scholarship
Full Scholarship Application

For Jumpstart (5-week) program. WBEC-East is proud to offer full scholarships for our FastTrac® and JumpStart programs through the support and partnership of generous corporate sponsors and individual donors. The WBC Scholarship Program will award one scholarship per entrepreneur to cover the full cost of one JumpStart course in order to assess, launch, and/or grow their business. Please note that that the following collection of demographic data is for WBEC-East to better understand the constituents we serve and is in no way used as scholarship eligibility criteria - providing this information is optional. Scholarship awards are limited. Scholarship applicants who are not awarded will still be considered for sliding-scale financial aid.
County
Race and Ethnicity
Age
Do you have a disability or disabilities?
Additional information based on previous question:
Do you identify as LGBTQIA+?

YesNoUnsure
What is your Veteran status?

I am a veteranI am not a veteranI am on active duty
Why are you interested in the Jumpstart program?*
2-4 sentences.
What is your "Why?" as an entrepreneur?*
2-4 sentences.
How does your business idea stand out amongst similar businesses in the area?*
2-4 sentences.
How does community involvement fit into your business idea?*
2-4 sentences.
I am able to attend (virtually or in-person based on the Cohort) all 5 JumpStart classes. Please compare JumpStart dates to your own calendar*

YesNoOther
What was your approximate household income from last year?*
Your best estimate is fine
How many people, including yourself, does that income support?*
Will your household income this year differ significantly from the previous year?*

YesNo
If yes, please explain:
What is your current employment status?*
Please explain any circumstances that make it difficult for you to pay the program fee below.*
3-5 sentences.
What part of the program fee could you pay?*
By signing this form, you agree that:

1). The information reported on this form is true, accurate and complete.

2). You authorize the Women’s Business Enterprise Center East to verify any of this information and request additional information as necessary.
Signature*

Clear
If you are unable to sign, please type your full name here.
Should be Empty:

Women's Business Center Financial Aid and Scholarship Application

Full Scholarship Application