Welcome! Before completeing this Application we recommend you thuroughly examine the www.PFAPNC.com website for answers and guidance.

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* 1. Applicant Name
(The Primary Applicant is the point person for all contact and will be the AUTHORIZED REPRESENTATIVE in all interactions with PFAP.)

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* 2. Business Name
(If you do not yet have a business name please type "TBD" and the primary applicant's last name.)

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* 3. Business Address
(Or personal address if no current assigned business address.)

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* 4. Phone

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* 5. E-mail

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* 6. Website
(If applicable)

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* 9. What date did you start or do you plan on starting your business.

Date

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* 11. Please tell us about your business and/or why you believe PFAP will be beneficial for you.

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* 12. Product Category (check all categories that apply)

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* 13. Please describe what products you wish to make, even if you already described them above.

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* 16. Do you have insurance for your business? If so, with whom?

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* 17. Insurance Information

Date
Date

T