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1. I certify that the information I will enter below is accurate to the best of my knowledge (Required.)

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2. Contact Information (applicants must be based in the US or one of its territories) (Required.)

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3. What is your title? (Required.)

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4. Website URL

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5. What is your company's NAICS code?

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6. What industry does your company belong to? (Required.)

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7. Please describe your company (Required.)

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8. Did you purchase your company?  (Required.)

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9. How many years has your company had a TaxID/EIN number? (Required.)

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10. How many full-time employees does your company have, aside from the company's owner(s)? (Required.)

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11. How many part-time employees does your company have, aside from the company's owner(s)? (Required.)

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12. What was your company's annual revenue in 2021? (Required.)

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13. What was your company's annual revenue in 2022?  (Required.)

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14. What is your company's current projected revenue for 2023? (Required.)

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15. What are the primary challenges your company is experiencing in growing a sustainable profitable business?  (Required.)

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16. Why are you interested in taking this course? (Required.)

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17. How did you hear about the Entrepreneurial Growth: Pathways to Profitability pilot course? (Required.)

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18. What other entrepreneurial courses have you taken? (Required.)

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19. Are you a former FastTrac student or graduate of FastTrac?  (Required.)

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20. If so, when did you take FastTrac?

Date

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21. How would you like to provide feedback during and after the course?

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22. What race and/or ethnicity do you publicly self-identify as? (Required.)

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23. What gender do you publicly self-identify as? (Required.)

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24. I agree that the Foundation may use my personal information to communicate with me about the Foundation and programs I may find interesting, to personalize my experience on Foundation websites, conduct academic/charitable research, collect data about me from other sources, and share my data with trusted Foundation affiliates. Please review our privacy policy which provides info on how we use, process, and protect your data. (Required.)

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