Application for Aspiring BAC 2010-2011

8/8/2019 Application for Aspiring BAC 2010-2011

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Business

Owner____________________________________________________________________

BusinessName______________________________________________________________

BusinessAddress_____________________________________________________________

City, State, Zip____________________________________________________________

Phone ( )_________________ Fax ( )_______________ Cell/Pager ( )______________

E-mail Address ________________________

Web Site Address _________________________________

Are you a member of the Jacksonville Regional Chamber of Commerce?

_____Yes _____No

Application for Aspiring

Business Advisory Council

S onsored in art b :


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General Questions:

1. Month/Year business began (if applicable) __________% of business owned one or more women__________

Does applicant actively manage the business? ____Yes ____ No

If yes, does applicant manage the business full-time or part-time? ____Yes ____ No

Number of employees (include applicant if applicable): Full Time______ Part Time______

Date fiscal year ends ____________________

Projected monthly sales or revenue

Last month _______

This month _______

Fiscal year _______

2. Do you have a business plan? Yes ____ No____ (if possible, please send business plan withapplication).

3. Briefly describe your goals for the business.Over the next one year:

Over the next three years:

4. Briefly describe your business products or services. Include any business literature withapplication.

Please describe any management needs you feel should be addressed immediately within yourbusiness. What keeps you awake at night?

____________________________________________________________________________________________________________________________________________________________

____________________________________________________________________________________________________________________________________________________________


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5. Business QuestionnaireHave you met any of the following criteria?

Determined your business structure Yes NoRegistered your business with the State of FLs Business & RegulationsDept.

Yes NoObtained business license Yes NoObtained an EIN from IRS Yes NoOpened a business checking account Yes NoObtained a Sales Tax Number (excluding service based companies) Yes NoPriced your services to generate revenue Yes NoGenerated at least $1 in revenue Yes NoSet up a recordkeeping system Yes NoSpoke with an experienced accountant and/or bookkeeper Yes NoWritten business processes (i.e. service agreements, contracts, policies &

procedures

Yes NoCreated marketing materials (e.g. business cards, brochure, etc.) Yes NoRegistered a domain name for your business Yes NoLaunched a functional website/company email addresses Yes NoSecured leased space for business (retail, service manufacturing, etc.) Yes NoPosted business operation hours Yes NoHired required staff Yes NoRegister ownership of a business acquisition Yes NoFor franchises, completion of terms of the franchise agreement Yes NoSecured financing Yes No

6. Other Comments: __________________________________________________________________________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

_____________________________________________________________________________


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The information contained in this application is provided for the purpose of informing the BACfacilitators as part of the JWBC peer-to-peer mentoring programs.

I represent that the information provided is true and complete. I understand this is a six (6) sessioncourse delivered over a three month cycle. The total cost of $195 is for the full six (6) sessions.

No adjustments or refunds will be made if the accepted enrollee does not attend all sessions.

Signature_____________________________________

Date___________________

Please return your completed application, attachments and your enrollment fee to:Pat Blanchard, Director

Jacksonville Womens Business Center

3 Independent Drive

Jacksonville, FL 32202

Phone (904)366-6640

Fax (904)366-6604

The Jacksonville Womens Business Center is a program of the Jacksonville Regional Chamber of Commerce Foundation, a

501(c)(3) organization. Jacksonville Women's Business Center is partially funded by the U.S. Small Business Administration's Officeof Women's Business Ownership (OWBO). SBA's cooperation does not constitute or imply its endorsement of any opinions,products or services. Reasonable arrangements for person with disabilities will be made if requested at least two weeks in advance.All SBA programs are extended to the public on a nondiscriminatory basis.

Documents

Application for Aspiring BAC 2010-2011