2019 Kaiser Permanente and ICCC Program Questionnaire

ICCC/VIB Nomination Application

The Veterans in Business Network is excited to support the 2019 Kaiser Permanente and ICCC Program. This is a unique program that is only offered to select businesses across the U.S. and this year, the VIB Network is thrilled to offer this program to our veteran business owners! There are 4 remaining cohorts for 2019; Baltimore, Los Angeles, Portland, and Honolulu.

Executive Training Day Dates:
Baltimore on Thursday, July 25th
Los Angeles on Tuesday, August 20th
Portland on Thursday, August 29th
Honolulu on Thursday, October 3rd

ICCC is a tuition-free, mini-MBA curriculum designed to help businesses grow and ultimately, access capital. It commences with a 1-day intense, executive training-day (see dates above) hosted by business school professors from Harvard, Dartmouth, and Northwestern universities. These professors will cover topics such as business strategy, sales & marketing, talent management, and small business finance. Each participating business owner will also be matched with a business advisor from Pacific Community Ventures and will be primed and prepped to pitch for capital.

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* 1. Address

Name

Company

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Website

Email Address

Phone Number

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* 2. Which ICCC Program location are you interested in participating?

Baltimore on Thursday, July 25th

Los Angeles on Tuesday, August 20th

Portland on Thursday, August 29th

Honolulu on Thursday, October 3rd

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* 3. Are you currently in the VIB Network Directory?

Yes

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* 4. Is your business?

Veteran Owned Small Business (VOSB)

Service-Disabled Veteran Owned Small Business (SDVOSB)

Disabled Veteran Business Enterprise (DVBE)

Other (please specify)

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* 5. Is your business?

For-profit

Non-profit

Partnership

Proprietorship

Other (please specify)

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* 6. Year Founded?

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* 7. What is your average annual revenue?

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* 8. Industry?

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* 9. What are your growth goals for your company?

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* 10. What are the barriers you are facing when growing your business?

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* 11. Why are you interested in participating in the ICCC program?

Thank you for applying for the 2019 Kaiser Permanente and ICCC Program.