Complete the eligibility questionnaire below for a chance to participate in the Starter Company Plus program. Space is limited, and only eligible entrepreneurs will be contacted to apply for the program. For more information, please contact us at 519-253-6900 or email Myrtle Donnipad at mdonnipad@windsoressexsmallbusiness.com.

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* 1. Email

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* 2. First Name

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* 3. Last Name

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* 4. Phone Number

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* 6. Company Name (if applicable)

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* 7. What products or services will your business offer?

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* 8. What city/town will your business be located?

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* 9. Are you currently working (outside of self-employment)?

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* 10. Does the business you're proposing or currently operating fall into any of the following categories (select all that apply, if applicable)?

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* 11. Are you currently or do you plan on becoming a full-time student?

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* 12. What is your highest level of education

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* 13. Are you a Canadian citizen or permanent resident?

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* 14. Are you a resident of Ontario?

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* 15. Are you prepared to commit to the Starter Company Plus program requirements (15 hours of business training, business plan submission and 3 months of mentor meetings)?

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* 16. Can you demonstrate 25% matching funds (personal cash contribution or in-kind assets) towards your business startup/expansion costs?

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* 17. Are you currently enrolled in a government entrepreneurship training/financing program?

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* 18. Have you received a business grant or loan in the past?

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* 19. Do you possess any experience, education or skills in the industry in which you want to operate a business? Please describe.

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* 20. Do you have a business plan complete for the business you are proposing? If so, please attach the document.

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