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APPLICATION
CONTACT INFORMATION
Woman Business Owner(s)
Business Name
Business Address
Address Line 1
Address Line 2
City
City
State
State/Province
ZIP/Postal Code
Country
Business Phone
Cell Phone
Email
Verify Email
Website
QUALIFICATION QUESTIONS
PERCENT OF BUSINESS OWNED BY BUSINESS OWNER
Month/Year business began.
(mm/dd/yyyy)
Does the Applicant actively manage the business?
Yes
No
Number of full time employees (include applicant if applicable):
Number of part time employees (include applicant if applicable):
Date fiscal year ends
(mm/dd/yyyy)
Sales or revenue history (use annual fiscal year numbers; do not include cents):
Last Fiscal Year $
Previous Fiscal Year $
2 Year Previous $
Projected for this fiscal year $
Budget for the next fiscal year
Is there anything the ATHENA PowerLink® Program should know about you or your business;
i.e., do you have any litigation pending? Are there significant personal or business financial difficulties of which we need to be aware?
Have you applied for an ATHENA PowerLink® Advisory Panel before?
Yes
No
If yes, when, and please describe why you did not receive one.
BUSINESS QUESTIONNAIRE
Do you have a business plan?
Yes
No
BRIEFLY DESCRIBE YOUR GOALS FOR THE BUSINESS
Over the next one year:
Over the next five years:
Do you have financial projections for the next one to two years?
Yes
No
If yes, please send financial projections with application.
Does your business currently have a board of directors?
Yes
No
If yes, how many directors, and describe their areas of expertise.
Do you expect any significant change in business ownership or operation during the next 18 months?
Yes
No
If yes, please describe.
Briefly describe your business’ products. Include any business literature with application.
Who are your three largest customers? Approximately what percentage of last year’s sales do they represent? Approximately what is your average size sale overall?
Briefly describe your business’ major strengths and major weaknesses.
Briefly describe your major competition and its/their strengths and weaknesses.
What are your primary tasks as president/owner? Which do you enjoy more: (a) running the business or (b) being in the industry?
What frustrates you most about running your business?
What is your highest business priority and how do you see an Advisory Panel being able to help you reach that priority?
Have you participated in a Small Business Administration Program such as SCORE or an SBDC? If so, please state when and describe how your business benefited.
What successful adviser/advisee relationships have you had while running this business? What good advice have they given you? How has this affected your business? Has it resulted in any lasting or permanent change?
ADDITIONAL INFORMATION PERTAINING TO YOUR APPLICATION
Include any additional information that you feel is important for consideration of your application.
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The information contained in this application is provided for the purpose of obtaining an unpaid Advisory Panel through the ATHENA PowerLink® Program.
I understand that ATHENA of the Triangle is relying on the information provided here to decide to grant an Advisory Panel, and therefore, I represent that the information provided is true and complete.
Please submit completed application and attachments by May 15, 2024.