Business Blitz Intake Form

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Thank you for your interest in being a participant in our program. Please read and fill out the information below to be considered. If you have any issues with your application, please email tcorbitt1@udayton.edu.

Are you available to commit to all three sessions at the Employment Opportunity Center at 4303 W Third St, Dayton, OH 45417? *

Yes

First Name *

Last Name *

Email Address *

Telephone *

Do you have any affiliation to the University of Dayton? If yes, please indicate what type? (Note: You DO NOT have to be affiliated with the University of Dayton to participate in this program.) *

Employee/Faculty

Student

Alumni

Participated in programs open to the community (I.e. capstone, STITT scholars, engineering program)

Flyer Pitch Contestant/Winner

I have no affliation to the University of Dayton.

Other:

Company Name *

Zip Code *

Do you have a website? *

Yes

Do you use social media to promote your business? *

Yes

Sometimes

Please describe your business. What do you offer? *

What is the legal structure of your business? *

I have not filed yet.

LLC

S Corp

C Corp

Nonprofit

Sole Proprietor

Is this your first business?
*

Yes

Maybe

Have you filed your Beneficial Ownership Information (BOI) form per the Corporate Transparency Act?
*

Yes

I don't know what this is

What is your long-term business goal?
*

Building a business that can be passed down to family or successors.

Maximizing the value of the business for a strategic exit.

Creating a business that supports my lifestyle and needs.

Developing a businesses that does not rely on me only and has employees.

Other:

Required

Which do you identify with?
*

Part-time Entrepreneur

Full-time Entrepreneur

Just Exploring Entrepreneurship

Other:

Income Level
*

$0-$30K

$30K-$60K

$60K-$90K

$90K-$100K+

Not Applicable / Not Started

Years in Business *

Less than a year

a year or more

three years or more

Is your business insured? *

Yes

Not sure

What are you most interested in learning about personal or small business finances? *

Please share the top three areas that you would like to improve in your business. *

Do you have a business bank account? *

Yes

Do you have an EIN (Employer Identification Number)? *

Yes

Do you have the necessary licenses you need for your business? *

Yes

Not Sure

Have you participated in any of the following GWDI programs? *

Urban Elevation Accelerator

Flyer Pitch Competition

Cultural Capital Microlending Program

GWDI Startup Fellowship

Power Hour

I have not participated in any other GWDI programs.

Required

How did you hear about the Business Blitz? *

Word-of-mouth

Social Media

Partner Referral

Traditional Media

GWDI Staff

Other:

PLEASE READ BEFORE YOU SUBMIT

By submitting this application, I hereby affirm that all information supplied is true and accurate to the best of my knowledge and belief, and I understand that this information will be considered material in the evaluation of my application to participate in the Business Blitz Bootcamp. I give the Greater West Dayton Incubator and the University of Dayton permission to send me email communications about events, programs, and entrepreneurship. I acknowledge that submission of this application does not guarantee admittance to the program.

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