Apply for the Boost Your Business Series!
Form must be submitted by 5 p.m. on Jan 31, 2024 for consideration for the next cohort ( Starting Feb 21st).
Sign in to Google to save your progress. Learn more
Name *
First and last name
Email *
Phone number *
Address *
Business Name *
How many Full-time employees do you have? *
Why would you like to attend the Boost Your Business Series? *
What do you hope to learn? *
Which Classes are you interested in attending? You may choose any that apply. *
Required
Lunches will be provided. Do you have any food allergies? If so, please list. *
Application Process

I understand the completion of this application does not guarantee my participation in the Spark Innovation Center Boost Your Business Series. 

Applications are due by 5 p.m. on Jan 31st, 2024 for the second cohort. Applications will be reviewed and selected applicants will be notified of their cohort selection(s) by Feb 2, 2024 for the first cohort. Cohort Selections are served on a first come, first served basis.

Each cohort will have up to 12 attendees. If space is available, attendees may be offered more than one cohort registration. Registrations will be paid for through grant funding. There is no cost to attend these classes for the applicants.

Informed Consent and Acknowledgement

In exchange for the acceptance of my candidacy by Spark, I assume all risk and hazards incidental to the conduct of the activities, and release, absolve and hold harmless Spark Innovation Center and the Town of Altavista and all its respective officers, agents, and representatives from any and all liability for injuries arising out of traveling to, participating in, or returning from selected cohort sessions.

In case of injury, I hereby waive all claims against Spark Innovation Center including all instructors and affiliates, staff, all participants, sponsoring agencies, advertisers, and, if applicable, owners and lessors of premises used to conduct the event. There is a risk of being injured that is inherent in all activities, including creative lab participation. I agree, if selected, to review the full Spark Innovation Center terms of use and complete waiver for Creative Lab Access. Inability or unwillingness to complete the two additional documents will result in attendee's inability to participate in cohort activities. 

Photo Media Consent

I give my permission to be included in photography, included but not limited to photos, website inclusion, newspaper, television and future promotion.

Please Select *
Confirmation

BY ACKNOWLEDGING AND SIGNING BELOW, I AM DELIVERING AN ELECTRONIC SIGNATURE THAT WILL HAVE THE SAME EFFECT AS AN ORIGINAL MANUAL PAPER SIGNATURE. THE ELECTRONIC SIGNATURE WILL BE EQUALLY AS BINDING AS AN ORIGINAL MANUAL PAPER SIGNATURE.

Signature *
Date *
MM
/
DD
/
YYYY
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Spark Innovation Center. Report Abuse
Google Forms