Initial Business Application

First Name*

Last Name*

Email Address*

Address Line 1*

Address Line 2

City*

State*

Zip Code*

How did you hear about us?*

Are you a Veteran? *

Yes

Are you currently employed?*

Yes

Were you born in the United States?*

Yes

Briefly describe any experience you have had that would help you in managing a unique business that specializes in customized family oriented services to our customers. Our customers include children, parents, families and our community.*

Have you taken any small business training classes? If so, what classes, when and where?*

Have you owned or do you own your own business?*

Yes

Business Name

Business Phone

Business E-mail

Business Website

Describe your business. What did you do?

Business Status

Type of Sales

Legal Status

Are you willing to share your financial analysis?*

What partnerships do you have or plan to establish with suppliers, retailers, distributors?*

Describe how you see yourself progressing in the next year to five years.*

Describe your business's personality externally. *

Describe your business personality internally. What do you want your company culture to embrace?*