BUILD Academy Application Cohort 6 BUILD (Businesses United in Leadership Development) Academy ProgramBUILD Academy helps entrepreneurs and small business owners in Little Rock strengthen their business foundations, connect with local resources, and expand their leadership skills. Please complete this application to be considered for the upcoming cohort. APPLICANT INFORMATION Question Title * 1. Full Name Question Title * 2. Email Address Question Title * 3. Phone Number (Mobile preferred) Question Title * 4. Home Address (Street, City, ZIP) Question Title * 5. Have you participated in BUILD before? Yes No Question Title * 6. If yes, why are you interested in joining BUILD again? Question Title * 7. How did you hear about BUILD? BUSINESS INFORMATION Question Title * 8. Legal Business Name Question Title * 9. Doing Business As (DBA) Question Title * 10. Business Type / Industry Professional & Technical Services Retail & Product-Based Services Hospitality & Food Services Health, Wellness & Personal Services Construction, Trade & Home Services Creative, Media & Entertainment Education & Training Transportation & Logistics Nonprofit & Social Enterprise Other Other (please specify) Question Title * 11. Business Entity Type Sole Proprietorship LLC Corporation Partnership Other Question Title * 12. Year Business Began Operations Question Title * 13. Business Owner’s Percentage of Ownership Question Title * 14. Business Phone Number Question Title * 15. Business Email Address Question Title * 16. Physical Business Address Question Title * 17. Mailing Address (if different) Question Title * 18. Is your business registered as a vendor with the City of Little Rock? Yes No Question Title * 19. Is your business registered with the Arkansas Secretary of State Yes No Question Title * 20. Do you have a current business license? Yes No Question Title * 21. Is this a Veteran-Owned Business? Yes No Question Title * 22. Do you hold any current certifications? (Example: SBA, HUBZone, or other recognized business certifications, etc.) Yes No Question Title * 23. If yes, please list which certifications: BUSINESS OPERATIONS Question Title * 24. Please provide a brief description of your business or business idea. Question Title * 25. Number of employees (including owner) Question Title * 26. Business Type Confirmation I have a business idea but have not started A for-profit organization A non-profit organization Question Title * 27. Do you work full-time within your business? Yes No Question Title * 28. 2024 Annual Business Revenue <$10,000 $10,000–$50,000 $50,000–$100,000 $100,000–$250,000 $250,000+ Question Title * 29. Did your business make a profit in 2024? Yes No Question Title * 30. Please describe any challenges or obstacles your business faced. Question Title * 31. Is your business forecasted to make a profit in 2025? Yes No PROGRAM INTEREST Question Title * 32. Why do you want to participate in BUILD Academy? Question Title * 33. What do you hope to gain or achieve through this program? CONSENTS & COMMITMENTS Question Title * 34. If selected, I pledge to make a good faith effort to attend and complete all BUILD Academy classes. I agree Question Title * 35. I grant permission to the City of Little Rock and BUILD Academy to use photos, video, or audio recordings taken during the program for promotional or educational purposes. Yes, I consent No, I do not consent Question Title * 36. Consent for data storage and processing: Yes, I give permission to store and process my data No, I do not give permission ATTESTATION I certify that I am the owner of the business named above and that the information provided is true and accurate to the best of my knowledge. Question Title * 37. Signature (Type your full name) Done
