60 Hour Entrepreneurial Training Program Application - Mid-Hudson 60 Hour Entrepreneurial Training Program Application - Mid-Hudson Please fill out the application below to be considered for the program. It will only take about 5 minutes to complete.Name* First Last Company Name Work PhoneHome or Mobile PhoneEmail* Address* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Are you a Veteran?* Yes No Type of Business you are interested in starting or expanding?Are you currently in business?* Yes No When did you start your business? Do you have a written business plan?YesNoPartial, needs workAre you currently working in your business? Yes No How many hours are you working in your business? How much do you plan to work in your business in the coming year?Full TimePart TimeUnsureIs your business earning enough revenue to cover expenses?YesNoUnsureIs your business making a profit?YesNoUnsureDo you have the resources (capital) to continue and/or expand your business?YesNoUnsurePlease enter the current status of your business idea.Do not yet know what type of business I wantHave business idea, but have not begun a bsuiness planIn process of developing/writing my business planIn process of starting a businessWill your business initially be home based?YesNoUnsureMost businesses take 1-3 years to generate a profit. Do you have the resources/money you will need to live on while you start your business?YesNoUnsureHave you previously owned a business? Yes No How much do you plan to work in your business in the coming year?Full TimePart TimeUnsurePlease describe your business or business idea further:*What unique need does your product/service address in the market?*What skills, talents, interests and passion provide you with the ability to fulfill that need?*Why do you think people will buy it from you?*Who is your competition?*Describe a typical customer for your product/service*Do you have a backup plan if your business does not succeed?* Yes No Is there anything else that you believe would help you with your business (i.e. family in the industry, strong community support, etc.)?*Please select the level of proficiency with the followingManaging files and folders*NoneBeginnerIntermediateAdvancedNot SureMS Word*NoneBeginnerIntermediateAdvancedNot SureMS Excel*NoneBeginnerIntermediateAdvancedNot SureInternet*NoneBeginnerIntermediateAdvancedNot SureEmail*NoneBeginnerIntermediateAdvancedNot SureHow often do you use the computer?*DailyWeeklyMonthlyRarelyNeverWhat programs do you use the most? (check all that apply)* MS Word or another word processing application MS Excel or another spreadsheet application PowerPoint Internet (web browsing, etc.) None of the above Can you open an application?*YesNoUnsureCan you use a printer?*YesNoUnsureCan you use a scanner?*YesNoUnsureDo you own a smart phone (blackberry, iPhone, etc.) or tablet?*YesNoUnsurePaste your resume or description of recent work history here.NameThis field is for validation purposes and should be left unchanged.
