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SJ BOOST Application
Thank you for your interest in the SJ BOOST Program for 2022 - 2023. Please complete the following application for consideration to participate as a business cohort, which will begin in Fall 2022.
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* Indicates required question
Email
*
Your email
SECTION 1:
BUSINESS INFORMATION
*
Business Name
Your answer
Business Street Address, City and Zip Code (example: 42 N. Sutter Street, Stockton, CA 95202)
*
Your answer
Business Phone Number - include area code and phone number
*
Your answer
Do you have a current business license to operate in the City of Stockton or within San Joaquin County?
*
Yes
No
Is your business licensed as a Home-Based business?
*
Yes
No
What is your business structure?
*
Sole proprietorship - one person owns the business and runs operations
Partnership - two or more people own and operate the business
Corporation - business is considered an entity and independent of its owners
S Corp - business structure like a corporation, but less than 100 shareholders....
LLC - an independent entity and you have filed your paperwork with the Secretary of State
How long has this business been established?
*
Not established
Less than 1 Year
1-5 Years
More than 5 years
Is your business owned by a Woman?
Yes
No
Clear selection
Is your business owned by a Veteran?
Yes
No
Clear selection
What type of business services or goods you provide?
*
Your answer
Is your business located in a rural community?
*
Yes
No
Is your business located in a low-income community?
*
Yes
No
Is your business located in a disaster impacted community?
*
Yes
No
What is the breakdown of the number of Full-time and Part-time employees you have, including yourself?
Your answer
SECTION 2:
YOUR CONTACT INFORMATION
Business Owner's Name
*
Your answer
Email Address
*
Your answer
Phone Number
*
Your answer
What is your Ethnicity?
*
African American / Black
Asian
Caucasian / White
Latinx or Hispanic
Native American
Pacific Islander
Other: ________________________________
Prefer Not to Answer
SECTION 3:
ACKNOWLEDGEMENTS
By submitting this application, I acknowledge the following: (Check all that apply)
*
My business is located in San Joaquin County
My business is at least 51% owned by a minority or woman, and I can provide proof of ownership if required.
My business has been in operation for at least one year
I can commit 4 hours per week for the duration of the SJ BOOST Program (estimated at 6 months)
Required
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