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Please complete all fields
Business Incubation Online Application
CONTACT INFORMATION
Company Name:
First Name:
Last Name:
Home Address:
City
State
-- Please Select a State --
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
American Samoa
Guam
Marshall Islands
Micronesia
Northern Marianas
Palau
Trust Territories
Virgin Islands
Armed Forces(AA)
Armed Forces(AE)
Armed Forces(AP)
Alberta
British Columbia
Manitoba
New Brunswick
Newfoundland
Northwest Territory
Nova Scotia
Ontario
Prince Edward Island
Quebec
Saskatchewan
Yukon Territory
Zip Code
Business Phone:
Home Phone:
E-mail:
Highest Level of Education:
Please Select
High School
Junior College
College
Technical/Specialized
Some Graduate School
Graduate Degree
Currently employed:
Please Select
No
Yes - Part Time
Yes - Full Time
Self-employed
-- If Yes, Where?
Have you ever taken any business courses or workshops?
Please Select
Yes
No
If yes, please explain:
BUSINESS TYPE
What type of business do you plan to start?
If starting a new business, do you have experience in that field?
Please Select
Yes
No
How long?
Not Applicable
1-3 Years
4-7 Years
8-10 Years
11+ Yrs.
What type of experience:
Have you ever owned a business?
Yes
No
Do you currently own a business?
Yes
No
If yes, how long?
1-3 Years
4-7 Years
8-10 Years
11+ Yrs.
Current number of employees:
Is your business legally established in the State of Florida?
Yes
No
If yes, Fictitious Name:
What year was it established?
Business Type:
Sole Proprietorship
Partnership
Limited Liability Company (LLC)
Type S Corporation
Type C Corporation
Non-Profit?
Yes
No
Do you have a valid County and City Occupational License?
Yes
No
Are you certified through any other agencies?
Please Select
MBE
Contractor/Builder
Other
BUSINESS PLANNING
Will your business need (check all that apply):
TED Center Office Space
Storefront
Warehouse
Other:
If other, please list:
Projected number of employees after working with the TED Center?
Number that can be hired from the target area?
Do you have a business plan?
Yes
No
Do you have a sales plan?
Yes
No
Do you have a written list of personal and business goals?
Yes
No
Have you prepared a proposed budget for your business?
Yes
No
Have you prepared a proposed budget for your personal finances?
Yes
No
How many hours a week can you commit to the TED Center Business Incubator developing your Business:
1 - 5 Hours
6 - 10 Hours
11+ Hours
What type of assistance are you seeking from the TED Center Business Incubator? Please Explain:
How did you hear about the TED Center Business Incubation Program?:
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