NAWBO-LA Application - Management Development for Entrepreneurs - 2019

NAWBO-LA is offering 3 scholarships to UCLA's Anderson School Management Development for Entrepreneurs Program (MDE).

MDE is designed for entrepreneurs and/or executives in existing businesses looking for entrepreneurial focused MBA concepts that will enhance their company’s management, revenues, profits and market impact. The program is a 10-day certificate program offered over three-day weekends on the UCLA campus. The dates are September 12-15, October 11-13, and November 1-3.

Two NAWBO-LA members will be selected to receive this scholarship, which is normally $4,500 to attend. To apply for the the scholarships please complete the following application.

*Submission does not guarantee that you will receive a scholarship.

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* 1. First Name:

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* 2. Last Name:

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* 3. Company Name:

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* 4. What is your position/title?

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* 5. What is your email?

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* 6. Gender:

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* 7. What is your age? (Optional)

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* 8. Company Website URL:

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* 9. Company Address:

Street:

City:

State:

Zip:

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* 10. Phone Numbers:

Company:

Home:

Cell:

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* 11. Do you have an assistant?

Yes

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* 12. What is the company's industry?

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* 13. List your company's products and services:

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* 14. Who are your major customers?

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* 15. Are you the owner/founder of the company?

Yes

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* 16. What year was the company founded?

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* 17. What year did you join the company?

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* 18. Name(s) of company founder(s):

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* 19. How many employees does the company have? Please include part-time and/or contract workers.

1-5

6-10

11-25

26-100

Over 100

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* 20. Please list your entrepreneurial experiences:

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* 21. Briefly explain why you are interested in the MDE program and what you hope to gain from it?

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* 22. List honors and awards you or your business have received:

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* 23. Does the company have any of the following certifications?

WBE

W/DBE

MBE

M/DBE

DBE

W/M/DBE

W/MBE

None

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* 24. What is the company's annual revenue?

Less than $499,999

$500,000 - $999,999

$1,000,000 - $4,999,999

$5,000,000 - $9,999,999

$10,000,000 - $50,000,000

Above $50,000,000

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* 25. Have you previously received or applied for a scholarship to attend MDE?

Yes

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* 26. Are you a Premier NAWBO-LA member?

Yes

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* 27. How long have you been a member of NAWBO-LA?

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* 28. What committee(s) are you involved in?

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* 29. Will you commit to the dates of the program?

Yes

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* 30. Will you commit to attend the graduation? The graduation will occur in January 2019 and may be weekend date.

Yes

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* 31. Will you promote the program and NAWBO-LA?

Yes