InnerCity Entrepreneurs

Re-Energize Class of 2004

Preliminary Application

Application Process

To apply, begin by completing the application and clicking send form.

Call with questions: 617-970-6346 or visit the website at www.bu.edu/ice/register/ICEPreliminaryApp.pdf to download this application or learn more.

All information will be kept strictly confidential and used for the sole purpose of applying to the program.

I. Applicant Contact Information

First Name     Last Name     Title

Business Name

Street

City    State AL AK AS AR CA CO CT DE DC FM FL GA GU HI ID IL IN IA KS KY LA ME MH MD MA MI MN MS MT NE NV NH NJ NM NY NC ND MP OH OK OR PW PA PR RI SC SD TN TX UT VT VI VA WA WV WI WY    Zip Code

Telephone     Fax

Business e-mail     Website

How did you hear about InnerCity Entrepreneurs?

II. General Business Information

Please provide a brief description of your business.

Please describe the nature of your business.

Construction

Financial

Manufacturing

Retail

Services

Distribution/Wholesale

Technology

Arts/Entertainment

Recreationtion/Tourism

Health Medical

Other(Please Specify)

When did you start your business? (MM/YYYY)  

Do you conduct any business on-line?    Yes   No

Please list your revenue, number of full-time employees, and number of part-time revenues for all the years below. If you were not in business during any of these years, please write NA.

YTD 2003 2002 2001 2000

Revenue

Full Time Employees

Part Time Employees

III. Business Education Information

What have been the primary business challenges for you over the past few years?

Have you sought assistance in overcoming these challenges?  Yes   No

If yes, please list the programs, resources, or networks you have used.

In your opinion, what worked and what did not work?

If no, why have you not sought assistance?

Please list any involvement you have in business or community organizations.

The Re-Energize program will be held every two weeks for approximately 3 hours over a six month period. Please mark ALL days and times that you would be willing to attend.  

Day

Monday Tuesday Wednesday Thursday Friday Saturday Sunday

Time (approximate times offered)

Morning (8-11am) Afternoon (1-4pm) Evening (6-9pm) Other