Growth Acceleration Services Application - Small Business Development Center of Northwest Florida

I understand my company needs to meet all minimum qualifications to be accepted into the Growth Acceleration Services.*

Yes, I agree.

Full Name*

First Last

Title

Company Name*

Email*

Business Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Daytime Phone*

Fax

Website

Business Type

Business Start Date*

Must be in business 3 or more years

Business NAICS Codes

Provide all that apply

Currently In Business

Yes
No

Gender

Race

Legal Structure

Must have a total of 5 or more employees

Number of Employees - Full Time*

Please enter a number greater than or equal to 0.

Number of Employees - Part Time*

Please enter a number greater than or equal to 0.

Veteran Status

Business Owner: Disabled or Handicapped?

Yes
No

Are you any of the following?

SBA Borrower
SBA Applicant
MBE Certified
8(a) Certified
Surety Bond
Import/Export
HubZone

2015 Total Revenue/Sales

Please enter a number greater than or equal to 0.

2016 Total Revenues/Sales*

Please enter a number greater than or equal to 0.

2017 Total Revenue/Sales*

Please enter a number greater than or equal to 0.

2018 Projected Total Revenue/Sales

Please enter a number greater than or equal to 0.

Annual Profit (Loss)

Please enter a number greater than or equal to 0.

Do you currently have a positive cash flow?

Yes
No

Additional Comments

What are your main products and services?

How do you currently market your products/services?

Who are your biggest customers?

Who are your major competitors?

What is your biggest challenge?

How do you hope to benefit from this service?

Do you have a business plan?

Yes
No

Do you have a budget?

Yes
No

Name

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