Brooklyn Business Mentoring Initiative Application

Instructions  Complete the following form and return it via email with any supporting documents to [email protected] by Friday, January 30th at 12:00 noon EST.  In the email subject heading include “Business Mentoring Application” with your FIRST and LAST NAME.

 In order to be considered, applicants must show they are invested in their business by submitting at least ONE of the below items:

o Draft Business Plan

o Proof of at least $1,000 invested in the business (website design, etc)

o Proof of Business Registration

All business plans and supporting documents will be kept confidential

Personal Contact Information First and last name: Home Address: Telephone Number: Email Address:

Business Contact Information (if applicable) Business Name: Business Address: Telephone Number: Website: BUSINESS DESCRIPTION: Please provide a brief background of the business and a description of the business model.

ENTREPRENEUR BACKGROUND: Please provide a description of your professional background. Include relevant business experience, certifications, completed coursework, awards, etc.

Return application via email to [email protected] by 1/30/15 @ 12PM EST. Selected participants will be notified in February 2015. BUSINESS MILESTONES: What accomplishments have you achieved to-date to work towards launching your business? (For example: Completed a business plan, interned/worked in a similar business, visited potential commercial locations, incorporated, launched business website.)

FINANCING: How much money have you invested so far into starting your business?

Return application via email to [email protected] by 1/30/15 @ 12PM EST. Selected participants will be notified in February 2015. GOALS: What are your goals for participating in this program? (Maximum of three) What business areas would you like to work on with a mentor?

If selected to participate in The Brooklyn Business Mentoring Initiative you confirm that you will:

1. Participate in at least SIX (6) hours of meeting time with your Mentor 2. Attend at least THREE (3) BOC no-cost workshops 3. Attend at least THREE (3) BOC one-to-one no-cost business counseling sessions 4. Attend the Launch and Closing Events 5. Complete and submit a Business Plan and Cash Flow Statement 6. Complete a Final Program Evaluation

Signature: ______

Date: ______

Return application via email to [email protected] by 1/30/15 @ 12PM EST. Selected participants will be notified in February 2015.