2022-2024 Starter Company Plus Program Application

2025-2026 Starter Company Plus Program Application
SECTION 1 - PERSONAL INFORMATION
First Name*
Last Name*
Birth Date*

YearMonthDay
Phone Number*

Area CodePhone Number
E-mail*
Proof of SIN# required if awarded micro-financing.
SECTION 2 - BUSINESS INFORMATION
Business Name*
If you do not have a business name, please enter your Full Name.
Business Address*

Street Address

Apartment

City Province

Postal CodeCountry
Business Status*

New Business (at least 6 months in operation)Existing Business (3 years old or less)
Length of Operation
In Years.
Do you have any employees?

YesNo
# Full-Time
If applicable.
# Part-Time
If applicable.
Business Sector*
SECTION 2A - BUSINESS INFORMATION - EQUITY WORKSHEET

Note: One of the requirements to qualify for micro-financing is to demonstrate a personal investment in the business of cash and/or in-kind equal to 25% of the maximum micro-financing amount of $5000. Therefore, the minimum personal investment required is $1250.
Please attach proof of your personal investment in your business and provide a breakdown here (Bank statements, receipts, etc.)
Please Calculate Total Cost of what you have spent in your business in the last 12 months

ASSETS (Investments in Business already bought and paid for)*

	Current Assets (describe in WORDS what you bought)	Cost $ (enter how much you paid or how much value is left)
Working Capital (e.g. cash in bank account, $500)
Merchandise/Inventory (e.g. 2 doz t-shirts).
Equipment (e.g. stand up mixer)
Tools (e.g. 4 Garden Rakes)
Supplies (e.g. office supplies: ink, paper)
Furniture/Fixtures (e.g. filing cabinet)
Technology (hardware/software e.g. laptop computer for biz)
Vehicle (specifically for the business)
Marketing: (e.g. business card/flyers/banners/signage)
Professionals: (e.g. accountant/lawyer/website developer)
Insurance (e.g. Professional General Liability Ins)
Other (e.g. permits/licenses)
Total [PLEASE ADD UP $]

Please attach proof of your personal investment of at least $1,250 dollars (Bank Statements, receipts, or a combination of both).

Upload a File
Can upload multiple files. File Types: pdf, jpg, png, txt, zip. Cancelof

Things needed (how will you spend the micro-finance funds if you receive it? Consider researching actual costs)*

	Things Needed (describe in WORDS)	Estimated Cost $
Merchandise/Inventory
Equipment
Tools
Supplies
Furniture/Fixtures
Technology (hardware/software)
Vehicle
Marketing: business card/flyers/banners, etc
Professionals: accountant/lawyer, etc
Insurance
Other (e.g. permits/licenses)
Total [PLEASE ADD UP $]

Notice of Collection and Privacy Practice:
Personal information is collected under the authority of section 108 of the Municipal Act, 2001 for the purpose of administering a counselling service to small businesses operating or proposing to operate within the Region of Durham. It will be used to determine program eligibility, for statistical reporting, and for outcomes follow-up and evaluation. Questions regarding the collection, use and sharing of your personal information should be directed to the Access and Privacy Office by email at privacy@durham.ca or by telephone at 905-668-7711, extension 2204. Please review the Region of Durham’s Privacy Statement (Privacy - Region of Durham) for more information.

Limitation of Liability:
The Business Advisory Centre Durham (BACD), a division of the Regional Municipality of Durham (Region), provides free information resources for general guidance on your business venture. This Information is not a substitute for professional advice. The Region and BACD do not offer legal, accounting, tax, or other professional advice. Consult a professional adviser before making any decisions regarding your business. While the Region and BACD strive to provide accurate Information, we cannot guarantee its completeness or timeliness. The Information is provided “as is,” without any warranties. The Region and BACD are not liable for any decisions made based on the Information or for any consequential damages.
Participant Name:*

First NameLast Name
Participant Signature
Agreement Date:*

DayMonthYear
DateHourMinutesAM/PM Option
BACD Representative

First NameLast Name
BACD Representative Signature
Agreement Date:

DayMonthYear
DateHourMinutesAM/PM Option
Section 4 - Internal Use - Micro-finance Disbursement Checklist
Learning Plan: Dates & Details
Micro-finance

AwardedNot Awarded
Not Awarded Note:
DISBURSEMENT: up to $5,000 in 2 payments (note: Maximum for equipment or one sole service/product is NOT 100% of the award funds.)
REQUIREMENTS MET**

Business Plan and Cash Flow provided supports award requested (break down of grant appears in Start Up Cost on 2-year cash flow)Signed agreement and signed release and consent form includedBACD recommends for business viabilityBACD has verified identification, business name registration (36 months or younger), and any required permits or licensing documentsGrant Recipient Completed all mandatory trainingGrant Recipient Committed to a site visit near end of termGrant Recipient Committed to mentor sessionsGrant Recipient Committed to providing business records of income and expenditures including receipts for the grant expenditures within first 90 days following receipt of grant paymentGrant Recipient Committed to submitting activity logs weekly and mentor worksheets after each mentor sessionGrant Recipient Committed to an Exit Interview and a Professional Report at end of termGrant Recipient Committed to completing participant surveys within two weeks of receipt
**Additional Requirements:
▪ In the case of an acquisition: Purchase offer and financial statements for the last two years
▪ If there are any cash shortages in the draft cash flow projections: Proof of corresponding business line of credit
▪ For existing businesses, Proof of monthly sales to date and balance of the company bank account
▪ For partnerships/corporations: Proof applicant holds majority share
▪ If the address does not match the piece of identification: Proof of address (e.g. utility bill)
▪ If applicable, signed contract or letter of intent
Disbursement Date:

DayMonthYear
DateHourMinutesAM/PM Option
Participant Name:

First NameLast Name
Participant Signature
BACD Representative

First NameLast Name
BACD Representative Signature
Should be Empty:

2025-2026 Starter Company Plus Program Application

SECTION 1 - PERSONAL INFORMATION

SECTION 2 - BUSINESS INFORMATION