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Jackson Drysdale Incubator Application
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1.
In order to apply for admission to the GI Go Fund Small Business Incubator, please read the following information about the requirements and the criteria with which we choose Incubator clients. If you feel that you meet the requirements and would like to apply to the program, below is a list of steps to be completed. Please contact us at 866-389-4446 should you have any questions or wish to schedule an appointment to meet with the Program Manager and/or tour the facility.
MINIMUM QUALIFICATIONS FOR CLIENTS
- Prior to acceptance, applicants and businesses must comply, or agree to comply, with all applicable local, state and federal regulations and ordinances, including applicable environmental laws.
- Business must not require use of manufacturing or chemical production. All incubator space provided will be in an office building, or be available virtually.
EVALUATION CRITERIA
Applicants will be evaluated based on the following key criteria:
- Potential for business growth and job creation.
- A need for the services of the Incubator and a willingness to accept assistance when indicated.
- The ability of the business to help diversify the local economy.
- The viability of the business and its potential for success.
- The business’ marketing opportunities and approach.
- The business’ management team.
- Resources available to the business.
- Technologies appropriate to the business.
- The compatibility of the business with the Incubator program and facility.
STEPS FOR CLIENT SELECTION
-Complete the application and submit by one of the following:
Mail or in person to:
GI Go Fund
1 Gateway Center, Suite 760
Newark, NJ 07102
Email: james@gigo.org
Phone: 866-389-4446
Fax: 732-377-8032
- We will review your application and you will be notified if your business is eligible for consideration. An appointment will be scheduled for a site visit and to discuss your application. You may need to then submit a copy of your business plan, including financial statements. If necessary, a second meeting will be scheduled to discuss the business plan. Members of the Selection Committee will review the business plan and if the business meets the evaluation criteria, and a meeting with the Selection Committee may be scheduled. You may be asked to meet with the Selection Committee at which time they may request additional information to establish or verify that the minimum qualifications are satisfied. You will be notified of their decision at the end of the meeting.
(Required.)
I Understand and Agree to proceed with my application
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2.
Date
(Required.)
Date
Date
January
February
March
April
May
June
July
August
September
October
November
December
1900
1901
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3.
Personal Contact Information
(Required.)
Applicant Name
Address
Address 2
City/Town
State/Province
AL Alabama
AK Alaska
AS American Samoa
AZ Arizona
AR Arkansas
CA California
CO Colorado
CT Connecticut
DE Delaware
DC District of Columbia
FM Federated States of Micronesia
FL Florida
GA Georgia
GU Guam
HI Hawaii
ID Idaho
IL Illinois
IN Indiana
IA Iowa
KS Kansas
KY Kentucky
LA Louisiana
ME Maine
MH Marshall Islands
MD Maryland
MA Massachusetts
MI Michigan
MN Minnesota
MS Mississippi
MO Missouri
MT Montana
NE Nebraska
NV Nevada
NH New Hampshire
NJ New Jersey
NM New Mexico
NY New York
NC North Carolina
ND North Dakota
MP Northern Mariana Islands
OH Ohio
OK Oklahoma
OR Oregon
PW Palau
PA Pennsylvania
PR Puerto Rico
RI Rhode Island
SC South Carolina
SD South Dakota
TN Tennessee
TX Texas
UT Utah
VT Vermont
VI Virgin Islands
VA Virginia
WA Washington
WV West Virginia
WI Wisconsin
WY Wyoming
ZIP/Postal Code
Country
Email Address
Phone Number
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4.
Website (if you do not currently have one, type n/a)
(Required.)
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5.
Business Contact Address
(Required.)
Company Name/Proposed Company Name
Business Address
Address 2
City/Town
State/Province
AL Alabama
AK Alaska
AS American Samoa
AZ Arizona
AR Arkansas
CA California
CO Colorado
CT Connecticut
DE Delaware
DC District of Columbia
FM Federated States of Micronesia
FL Florida
GA Georgia
GU Guam
HI Hawaii
ID Idaho
IL Illinois
IN Indiana
IA Iowa
KS Kansas
KY Kentucky
LA Louisiana
ME Maine
MH Marshall Islands
MD Maryland
MA Massachusetts
MI Michigan
MN Minnesota
MS Mississippi
MO Missouri
MT Montana
NE Nebraska
NV Nevada
NH New Hampshire
NJ New Jersey
NM New Mexico
NY New York
NC North Carolina
ND North Dakota
MP Northern Mariana Islands
OH Ohio
OK Oklahoma
OR Oregon
PW Palau
PA Pennsylvania
PR Puerto Rico
RI Rhode Island
SC South Carolina
SD South Dakota
TN Tennessee
TX Texas
UT Utah
VT Vermont
VI Virgin Islands
VA Virginia
WA Washington
WV West Virginia
WI Wisconsin
WY Wyoming
ZIP/Postal Code
Country
Email Address
Phone Number
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6.
Is your business new or existing?
(Required.)
New
Existing
7.
If it is an existing business, how long has it been in existence?
8.
If this is a new business, what steps have you taken towards establishing your business? (150 words)
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9.
Describe the stage of development your business is in at this time: (250 words or less)
(Required.)
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10.
Ownership Type
(Required.)
Sole Proprietorship
Partnership/LLC
Corporation
Other
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11.
Names, addresses, phone numbers of additional principals, partners, or major shareholders:
(Required.)
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12.
Briefly describe your business, its products and markets: (350 words or less)
(Required.)
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13.
Describe your background or experience with the product/service of the business: (350 words or less)
(Required.)
14.
Do you have a product or technology that can be patented, trademarked or protected from duplication (if applicable)?
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15.
Your reason for seeking entry into the program: (500 words or less)
(Required.)
16.
How much money do you have invested in this business?
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17.
How do you intend to capitalize or finance this business? (500 words or less)
(Required.)
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18.
Estimated number of employees at time of occupancy:
(Required.)
Full-time
Part-time
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19.
Estimated number of employees after one year
(Required.)
Full-time
Part-time
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20.
Two Years
(Required.)
Full-time
Part-time
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21.
Three Years
(Required.)
Full-time
Part-time
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22.
Do you anticipate your business having special facility needs (high voltage, refrigeration, special security, etc.)? If yes, please explain
(Required.)
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23.
Do you expect to use any hazardous or toxic materials? If so, describe:
(Required.)
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24.
Do you currently have the following? (Check all that apply):
(Required.)
Business plan
Business plan outline
Market/feasibility study
Required business permits
Current financial information for business and/or principals
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25.
Do you need assistance to create or complete your business plan?
(Required.)
Yes
No
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26.
What are your business strengths? (150 words or less)
(Required.)
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27.
What potential problems do you foresee in your business, and/or in entering your market? (350 words or less)
(Required.)
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28.
Check areas of assistance your business needs beyond office space:
(Required.)
Strategy
Management
Financial
Assembly/Manufacturing
Legal
Facilities
Technical
Marketing
Other (please specify)
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29.
Requested date of occupancy
(Required.)
Date
Date
January
February
March
April
May
June
July
August
September
October
November
December
1900
1901
1902
1903
1904
1905
1906
1907
1908
1909
1910
1911
1912
1913
1914
1915
1916
Su
Sunday
Mo
Monday
Tu
Tuesday
We
Wednesday
Th
Thursday
Fr
Friday
Sa
Saturday
01
02
03
04
05
06
07
08
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30.
Are you a Military Veteran?
(Required.)
Yes
No
31.
If not, are you the spouse, child, or dependent of a veteran?
Yes
No
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32.
Did you serve in a combat theater?
(Required.)
Yes
No
33.
If yes, which one?
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34.
What branch did you serve in?
(Required.)
35.
Date of Discharge
Date
Date
January
February
March
April
May
June
July
August
September
October
November
December
1900
1901
1902
1903
1904
1905
1906
1907
1908
1909
1910
1911
1912
1913
1914
1915
1916
Su
Sunday
Mo
Monday
Tu
Tuesday
We
Wednesday
Th
Thursday
Fr
Friday
Sa
Saturday
01
02
03
04
05
06
07
08
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36.
Type of discharge
(Required.)
Honorable
Other than Honorable
General/Medical
Dishonorable
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37.
Please provide any additional information you feel is relevant (350 words or less):
(Required.)
*
38.
Are you a person of color?
(Required.)
Yes
No
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39.
Are you a person with a disability?
(Required.)
Yes
No
Current Progress,
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