Growth Acceleration Services ApplicationI understand my company needs to meet all minimum qualifications to be accepted into the Growth Acceleration Services.* Yes, I agree.Full Name* First Last TitleCompany Name*Email* Business Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanÅland IslandsAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarrussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRéunionRomaniaRussiaRwandaSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUS Minor Outlying IslandsUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabwe Country Daytime Phone*FaxWebsite Business TypeRetailManufacturingConstructionWholesaleServiceOtherBusiness Start Date* Must be in business 3 or more yearsBusiness NAICS CodesProvide all that applyCurrently In BusinessYesNoGenderMaleFemaleRaceWhiteBlackAsianNative 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?YesNoAre you any of the following? SBA Borrower SBA Applicant MBE Certified 8(a) Certified Surety Bond Import/Export HubZone2015 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?YesNoAdditional 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?YesNoDo you have a budget?YesNoCommentsThis field is for validation purposes and should be left unchanged.
