Mind Your Business Mastermind Application

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If you have questions, or would like help, please contact Tina at info@businessesofcolor.org. These questions are required by the grant that funds this program through Washtenaw County. We will be in touch with you about next steps!

Email *

Your Name (First and Last) *

Phone Number *

Home Address *

Business Name *

How many years have you been in business? *

What kind of business do you have?

Agriculture & Forestry

Marketing, Technology and other Business Services

Construction, Utilities, Contracting Services

Childcare and Education Services

Motor Vehicle

Personal Services (personal care, entertainment, fitness, photography, cleaning, etc.)

Real Estate & Housing

Finance/Accounting, Insurance, and Taxes

Transportation

Food and Hospitality

Healthcare services

Other:

Clear selection

Business Address (Please include your Street, City, and Zip Code) *

This program is for small business owners that qualify according to their household income. (For example: if you made $24,000 from your business after paying expenses, and you live with your spouse who makes $30,000. Your total household income is $54,000.) Please check one box. *

I have 1 person in my household and my income is less than $58,900.

I have 2 people in my household and the total household income is less than $63,950.

I have 3 people in my household and the total household income is less than $71,950

I have 4 people in my household and the total household income is less than $79,900.

I have 5 people in my household and the total household income is less than $86,300.

I have 6 people in my household and the total household income is less than $92,700.

I have 7 people in my household and my total household income is less than $99,100.

I have 8 people in my household and my total household income is less than $105,500.

I have over 8 people in my household.

None of these statements are true for my/our household.

What Is Your Gross Annual Revenue in 2021 or 2020? (Your gross annual revenue is how much your business took in, before you paid any expenses, subcontractors, etc.) *

How many years old is your business? *

Were you in business on (or before) March 16, 2020? *

yes

How was your business established on (or before) March 16, 2020 *

LLC

S-Corp

DBA (Doing Business As)

Sole Proprietorship

Other

Does your business exist now? *

No, I closed my business but will re-open it.

Yes, my business is still going.

Is your business relocating? *

Yes

How did Covid-19 affect your business? *

My business had to shut down or reduce hours during the COVID-19 pandemic due to required closings, lack of childcare, etc.

My business had to lay off staff due to the COVID-19 pandemic

My businesses experienced unexpected cost increases (such as personal protective equipment, retrofitting spaces to accommodate social distancing requirements, etc.) due to the COVID-19 pandemic

My business slowed, or had less clients or customers.

Other:

Did you business receive any technical assistance (help with training, learning, or other support) or grants due to the impact of the pandemic? *

Yes

If I qualify for this program, I agree to provide a copy of my most recent household taxes, and documentation that you were operating a business as of March 16, 2020, such as: Limited Liability Company Articles of Incorporation, Sole Proprietorship documentation, Business Taxes from 2020 or Other. *

Yes

What is your race? (Not a factor in qualifying— this is for grant reporting purposes only.) *

White

Black/African American

Black/African American & White

Asian

Asian & White

American Indian/Alaskan Native

American Indian / Alaskan Native & Black / African American

American Indian/ Alaskan Native & White

Native Hawaiian / Other Pacific Islander

Other Multi-Racial

Hispanic/Latino Ethnicity *

Yes

My business is: (Check all that apply.) *

Woman-Owned

Military Veteran-Owned

Disability-Owned

None of the Above

Required

Number of employees including the owner. *

Why are you interested in the Mind Your Business mastermind program? What do you hope to accomplish? *

Send me a copy of my responses.

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