ENTREPRENEURIAL TRAINING PROGRAM APPLICATION
SMALL BUSINESS DEVELOPMENT CENTER at UW-Stevens Point
(FOR WISCONSIN RESIDENTS or THOSE WHO OWN A WISCONSIN BUSINESS)
Applicant Information
(Name of individual applying for ETP)
First:
Salutation:
MI:
Ms.
Mrs.
Mr.
Dr.
Last:
Business Name (if available):
Address:
City:
State:
Phone Number:
Race:
Zip Code:
County:
E-mail address:
Asian
Black
Native American/Alaska Native
Are you of Hispanic Ethnicity?
Do you have a disability?
Yes
Yes
Veteran Status:
Non-Veteran
Military Status:
Not Military
No
Native Hawaiian/Pacific Islander
Gender:
Male
White
Female
No
Veteran
Service-Connected Disabled Veteran
Reserve/National Guard
On Active Duty
Business Information
Business Status:
Nascent (not yet in business)
Startup
Established
High Growth
NAICS (if known):
If you indicated that you are in business (startup, established, or high growth) please provide the information below. If your
business is nascent, proceed to the “Course Information” section.
Female Ownership (0-100%):
Business Organization:
# of Employees: FT:
Business Start Date (MM/DD/YYYY):
Sole Proprietorship
Partnership
LLC
Undecided
PT:
Corporation
Annual Sales $$:
S Corporation
Annual P/L $:
Course Information
Host Organization: SBDC at UW-Stevens Point
Start Date:
Course Fee: $1000 – stipend = $250
ENTREPRENEURIAL TRAINING PROGRAM
APPLICATION (Page 2)
SMALL BUSINESS DEVELOPMENT CENTER at UW-Stevens Point
(FOR WISCONSIN RESIDENTS or THOSE WHO OWN A WISCONSIN BUSINESS)
Additional Information about your proposed/existing business
(used to evaluate your application)
What is your business idea (include products or services)?
Who is the customer (to whom are you selling)?
Why will people buy your products or services (what makes your idea special)?
What makes you think you will be successful?
• Relevant education:
• Relevant previous experience:
• Partners and management:
• Funding sources:
• Other:
Use additional sheets if necessary. Please be specific about your answers.
ENTREPRENEURIAL TRAINING PROGRAM APPLICATION (Page 3)
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THE APPLICANT
Certifies that to the best of his/her knowledge and belief, the information being submitted on this application is
true and correct.
Understands that admission to this program is a competitive process and that not all applications are funded.
Certifies that the 25% matching funds provided by the applicant are not provided by other state sources.
Agrees to pay the SBDC $650 if a completed business plan is not submitted and accepted by the SBDC within 90
days of completion of the course.
Agrees to complete and submit two evaluation surveys: one at the end of the Course and the other eighteen
months after completing the course.
Agrees to release a copy of the Business Plan to be funded by this application to the SBDC.
Applicant certifies that he/she has not declared bankruptcy during the past 12 months.
Understands that only one individual per business is eligible to receive this grant.
The SBDC will keep your business plan confidential. However, for promotional purposes, may we release your:
Yes
No
a) Name?
b) Business name and location?
I understand and agree to these terms
(Serves as an electronic signature if emailing form)
Applicant Signature
Date
Printed Name
Date
Applicant Computer Skills Questionnaire
Access to a computer and basic computer skills are necessary for this training program.
Do you have access to a computer?
Yes
No
Do you have access to the internet?
Yes
No
How would you rank your computer skills?
1
2
3
4
5
(1=no experience to 5=very experienced)
What type of computer do you use (Mac, PC)? __________________________________________
What Word Processing software do you use? ___________________________________________
(Microsoft Word, Works, WordPerfect, etc.)
What version of that software?________________________________________________
What Spreadsheet software do you use?_______________________________________________
(Microsoft Excel, Works, Quattro Pro, Lotus, etc.)
What version of that software? ________________________________________________
FOR SBDC USE ONLY
Course ID #:
Based on the limited introductory information:
Does this idea seem viable in the market?
Does applicant have a good understanding of the customer?
Does the applicant have sufficient management skills?
Signature below authorizes:
DENIAL
Yes
No
APPROVAL
SBDC Reviewer:___________________________________
Date: __________________________