Growth Acceleration Services Application 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 AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Daytime Phone*FaxWebsite Business TypeRetailManufacturingConstructionWholesaleServiceOtherBusiness Start Date* MM slash DD slash YYYY Must be in business 3 or more yearsBusiness NAICS Codes Provide all that applyCurrently In Business Yes No GenderMaleFemaleRaceWhiteBlackAsianNative AmericanHawaiian or Pacific IslanderOtherLegal StructureSole ProprietorS-CorpPartnershipLLCCorporationUndecidedMust have a total of 5 or more employeesNumber 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 StatusNon-VeteranGulf War VeteranVeteranVietname Era VeteranDisabled VeteranService-Connected DisabilityBusiness 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/SalesPlease 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/SalesPlease 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 CommentsWhat 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 CommentsThis field is for validation purposes and should be left unchanged.
