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WE CAN GROW Program Application

Thank you for interest in WE CAN’s GROW Program

GROW Program Dates:

Young/New businesses - Facilitated by Michele Rocray:

6 Tuesdays 9 AM -12 PM in Harwich (Excluding school vacation week)

Start: April 8th
End: May 20th
Location: Harwich

Please take your time and answer all questions as completely as possible. It should take about 10 minutes. Each question helps us understand your needs and make sure that the GROW Program is right for you and your business.

Part 1: Your Information

(Items marked with an * are required)

Date

First Name

Last Name

Preferred Phone

By providing a telephone number and submitting the form you are consenting to be contacted by SMS text message. Message & data rates may apply. Reply STOP to opt out of further messaging.

Phone Type: * Obligatorio

Cell

Home

Business

Other

OK to leave message? * Obligatorio

Yes

No

OK to leave text? * Obligatorio

Yes

No

Email

Mailing Address

City

State

Zip

Residence Address (If different from above)

City

State

Zip

Check here if you DO NOT want our newsletter

Check here if it is ok to share contact information among GROW group members

Marital status: * Obligatorio

Single

Married

Widowed

Domestic Partner

Divorced

Separated

Highest level of education: * Obligatorio

Less than 12

12

GED

12+

Associate Degree

Bachelor's Degree

Master's Degree

Advanced Degree

Other

Date of Birth

Housing Situation: * Obligatorio

Own

Rent

Living w/ Friends or Family

Other

Employment Status: * Obligatorio

Employed

Self-Employed

UNDER Employed

Retired

Unemployed

Part 2: BUSINESS Information

For this next portion of the application, do not worry if you don't know the answers to some of these questions. This is a great way to track your progress through the GROW program. Please answer each question to the best of your ability.

Name of Business

Product or Service

Business Address (If different from home)

City

State

Zip

Website

SOCIAL MEDIA

Facebook

Instagram

X (Twitter)

Other social media

ECOMMERCE SITES

Etsy

Amazon

Other ecommerce site

How would you classify your business? *

Pre Start Up - a business that is estimated to be within 12 months of opening and generating revenue

Start Up - a business that is open and generating revenue but has not yet experienced significant growth

Established - a business that is (or was) profitable and employs at least one full time employee (FTE)

Date business was/will be established

Type of Business: * Obligatorio

Sole Proprietor

Partnership

LLC

S Corporation

C Corporation

Other

Please specify

Describe your primary role in the business

# of Full Time Employees

# of Part Time Employees

# of Full Time Seasonal Employees

# of Part Time Seasonal Employees

In the next 12 months, do you plan to add employees? * Obligatorio

Yes

No

If yes, how many employees would you add?

Approximate Annual Revenue

Is your business profitable? *

Yes

No

I don't know

Are you willing to share business financials with the group?*

Yes

No

*Necessary to be accepted into the group

What do you hope to gain from participating in the GROW group?

What led you to your business?

Describe your short-term goals for the business

Describe your long-term vision for the business

What are you most excited about regarding your business?

What are you concerned about / challenged regarding your business right now?

Check all organizations you have worked with in the past or are currently woring with * Obligatorio

E for All

CDP

SCORE

Other

If other, please specify

Check each area you are most interested in learning about: * Obligatorio

Growing a business

Developing a business plan

Sales and Marketing

Budgeting/Determining profitability

Pricing

Obtaining financing/credit

Being the boss/Managing people

Information on courses, training, etc.

Other

Please specify

Status of business plan? *

Current

Need one

Needs updating

Other

If other, please specify

Do you have a business relationship with a bank? *

Yes

No

Describe your support system (family, friends, colleagues) in running your business.

Part 3: DEMOGRAPHICS

WE CAN & the Community Development Partnership received grant funding by the Massachusetts Growth Capital Corporation for this program. Please help us keep this funding by allowing us to collect and share information about our participants. The following information is used for statistical and grant purposes for WE CAN and CDP.

*No identifiable information is shared with the funder*

Gender * Obligatorio

Male

Female

Other

If other, please specify

Ethnicity * Obligatorio

Non-Hispanic/Latino

Hispanic/Latino

Race/National Origin * Obligatorio

American Indian/Alaskan Native

Asian

Black/African American

Native Hawaiian/Other Pacific Islander

White

Other

Please specify

Citizenship: *

I decline to answer

I am a citizen of the United States

I reside in the United States after being legally admitted permanent residence

Military status:

Active military

Reserve

Veteran

Ability Status: *

Able bodied

Disabled

Prefer not to answer

I give permission for my information to shared with CDP for grant purposes only:

Initial here:

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WE CAN is a registered 501 (c)(3): 31-1777179

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