Rotary Atlanta West End Microbusiness Program

Application for West End Entrepreneurs

Thank you for your interest in the Rotary Club of Atlanta West End Microbusiness Program, designed to provide small business education, mentoring, resources, and loans to entrepreneurs serving Atlanta's West End neighborhood. If you have questions about this application or about the program, please email AWE.Microloans@gmail.com.

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* 1. Your name

First Name

Middle Name

Last Name

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* 2. Your address

Street Address

City

State

Zip Code

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* 3. Is your home, current business, or office/employer located in the West End?

Yes

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* 4. Best phone number to contact you

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* 5. Your email address

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* 6. The selection process may include an interview. Please indicate the best time of day to schedule your interview.

Daytime

Evening

No preference

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* 7. Following the selection process, an orientation will be held. Applicants will then be required to attend an eight week (once weekly during the evening) course of business education/training provided by Atlanta Technical College free of charge. This eight week course will take place from approximately March 15 through May 15. Please check your calendar. If selected, are you able to attend 100% of these classes?

Yes

I plan to attend all classes, pending finalization of the course dates.

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* 8. How long have you been in business?

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* 9. Does your business currently have a presence on the internet? If so, please share your web address(es) below.

Website

Facebook

Twitter

Linked In

Other

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* 10. What is the name of your business?

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* 11. Does your business have a state or federal identification number?

Yes, I have a state number.

Yes, I have a federal number.

No, my business does not have a state or federal ID number.

If your business has a state or federal identification number, please list it here.

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* 12. Do you have a business license?

Yes

If yes, please indicate the government entity that issued the license.

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* 13. Describe the nature of your business.

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* 14. How will this program allow you to increase revenue?

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* 15. How can this program make a lasting difference in your business?

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* 16. What else would you like us to know about you?

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* 17. Please rank the following according to their value/interest to you, with #1 being the highest value/interest and #5 being the lowest.

Mentorship

Networking/peer meetings

Business education training

Micro-loan

Continuing education workshops

Professional services, e.g., accounting, marketing, social media

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* 1. Your name

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* 2. Your address

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* 3. Is your home, current business, or office/employer located in the West End?

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* 4. Best phone number to contact you

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* 5. Your email address

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* 6. The selection process may include an interview. Please indicate the best time of day to schedule your interview.

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* 8. How long have you been in business?

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* 9. Does your business currently have a presence on the internet? If so, please share your web address(es) below.

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* 10. What is the name of your business?

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* 11. Does your business have a state or federal identification number?

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* 12. Do you have a business license?

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* 13. Describe the nature of your business.

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* 14. How will this program allow you to increase revenue?

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* 15. How can this program make a lasting difference in your business?

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* 16. What else would you like us to know about you?

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* 17. Please rank the following according to their value/interest to you, with #1 being the highest value/interest and #5 being the lowest.

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* 18. How did you hear about the Rotary Club of Atlanta West End's Microbusiness Program?