About Us
What We Do
Board of Directors
Our Staff
Our Commitment to Equity
Job Opportunities
Celebration
Events Calendar
Celebrate Freedom Events
Marshall Awards
Summer Fest
Veterans Day
Historic Event Venues
Education
Events Calendar
Tours
Preservation
Historic Property Rentals
Providence Academy
Providence Academy Preservation & Renovation
Providence Academy Small Business Incubator Program
Sacred Heart Plaza at Ed Lynch Square
Event Venues
Parking Lot Leasing
Get Involved
Volunteer
E-Newsletter Sign Up
Become a Sponsor
Donate
Donate
Individual Giving
Gifts from Wills and Beneficiary Designations
Create a Legacy
About Us
What We Do
Board of Directors
Our Staff
Our Commitment to Equity
Job Opportunities
Celebration
Events Calendar
Celebrate Freedom Events
Marshall Awards
Summer Fest
Veterans Day
Historic Event Venues
Education
Events Calendar
Tours
Preservation
Historic Property Rentals
Providence Academy
Providence Academy Preservation & Renovation
Providence Academy Small Business Incubator Program
Sacred Heart Plaza at Ed Lynch Square
Event Venues
Parking Lot Leasing
Get Involved
Volunteer
E-Newsletter Sign Up
Become a Sponsor
Donate
Donate
Individual Giving
Gifts from Wills and Beneficiary Designations
Create a Legacy
Providence Academy Small Business Incubator Application
"
*
" indicates required fields
CONTACT INFORMATION
Name
*
First
Last
Home Address
*
Street Address
City
State / Province / Region
ZIP / Postal Code
Length of Time at Home Address
*
Phone
*
Email
*
Date of Birth
*
MM slash DD slash YYYY
BUSINESS PROFILE
Legal Business Name
*
DBA (if applicable)
Type of Business
*
Corporation
Individual/Sole Proprietor
Partnership
Other (specify)
Other Type of Business
Website
Phone
*
Email
*
Local Address
*
Street Address
City
State / Province / Region
ZIP / Postal Code
Length of Time at Business Address (if applicable)
Principal Address
Street Address
City
State / Province / Region
ZIP / Postal Code
Nature of Business
*
If incorporated, where?
Tax ID or EIN #
*
UBI #
Current # of Employees
Full Time
Part Time
Business Owner Name(s) - List all owners and their percentage of ownership
Owner 1 Name
Owner 1's % of ownership
Owner 2 Name
Owner 2's % of ownership
Owner 3 Name
Owner 3's % of ownership
Owner 4 Name
Owner 4's % of ownership
Your Gross Monthly Income (based on the past 12 months)
*
Bank Name
Branch Location
Phone
Business Mentor Name
*
Business Mentor's Organization/Company Name
*
# Hours consulting with Business Mentor as of today's date
*
Is your business a current member of Vancouver's Downtown Association?
*
Yes
No
Is your business a current member of the Greater Vancouver Chamber of Commerce?
*
Yes
No
Is your business BIPOC-owned or led?
Yes
No
Is your business female-owned or led?
Yes
No
Is your business certified with the Washington State Office of Minority & Women's Business Enterprises?
Yes
No
Is your business eligible to be certified with the Washington State Office of Minority & Women's Business Enterprises, but has not applied or been certified yet?
Yes
No
Does Not Apply (Already Certified)
Business References
Reference #1 - Contact
Company
Phone
Email
Reference #2 - Contact
Company
Phone
Email
Business Plan
*
Max. file size: 15 MB.
Financial Plan
*
Max. file size: 15 MB.
Personal Financial Statements
Max. file size: 15 MB.
Providence Academy Suite Desired
*
VIEW OFFICE SUITE SPECIFICATIONS
Have you scheduled an in-person site visit of this space?
*
Yes
No
If yes, date of site visit
MM slash DD slash YYYY
Please explain why this space would be a good fit for your business (maximum 3,000 characters with spaces)
*
How have you raised funds for your business so far (Go Fund Me, other grants, investors, etc.)? (maximum 1,500 characters with spaces)
*
How have you used resources to gain traction toward reaching your business goals? (maximum 3,000 characters with spaces)
*
Please share anything else you'd like the committee to consider (maximum 3,000 characters with spaces)
Consent
*
I certify that the above information is correct and complete. I am an authorized representative of the above named company/organization.
*
Consent
*
I understand that I may be required to provide additional personal and/or financial information to process the credit and background check screening.
*
Consent
*
I understand that this application will be reviewed by a grant selection committee, and upon determination of an award, I will be asked to submit a $50 screening fee and undergo a credit report, landlord verification, background check, and references checks prior to award confirmation.
*
Consent
*
I understand that if an award is confirmed, I must sign a custom lease agreement that personally guarantees monthly lease payments (even if your business is an LLC), which includes payment schedule and repercussions for non-payment, I must follow all rules and regulations for leasing space at Providence Academy, and obtain and maintain renters insurance throughout the duration of the lease. I must also participate in check-in meetings every six months through the duration of the 18-month program.
*
Name
*
First
Last
Date
*
MM slash DD slash YYYY
Signature
*
Comments
This field is for validation purposes and should be left unchanged.
