2023 INCspire Bizmaker Grant Program Application Deadline is Friday, March 31, 2023 Applicant Information Applicant Name * Applicant Title * Contact Email Address * Contact Phone Number * Business Information Business Name: * Business DBA (if applicable): Business Legal Address Address Line 1 Address Line 2 City State Select option... Alabama Alaska Arizona Arkansas California Colorado Connecticut DC Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming DC Zip/Postal Code Business Mailing Address (if different) Address Line 1 Address Line 2 City State Select option... Alabama Alaska Arizona Arkansas California Colorado Connecticut DC Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming DC Zip/Postal Code Program Questionnaire * Yes No If selected, will you commit to at least four (4) quarterly meetings over a one-year period with an INCspire mentor? These meetings are to develop strategies to grow your business and best utilize grant proceeds for their stated purposes. Yes No Is the entity a currently registered business in Fairfax County? Yes No Does the business entity have at least one principal who is a legal resident of the United States and at least 18 years old at the time of application? Yes No Upload a document that describes how your product or service is unique and innovative and how it can create value for existing and potential clients? Video submissions preferred, however, written responses accepted. Word count limit is 1000. * Upload a document that addresses how the grant prize dollars will be utilized to meet your business’ strategic growth goals? Provide a realistic and well-articulated plan for use of the allocated funds. Video submissions preferred, however, written responses accepted. Word count limit is 1000. * Upload Business Plan Executive Summary * Upload Most Recent Financial Statement * Most recent annual financial statements – income statement, balance sheet, statement of cash flow. For start-up organizations, please present a three year financial projection. Explanation of Extraordinary Events If applicable, an explanation of extraordinary events impacting financial performance that you wish to have included in the evaluation process. Video Pitch (Submission may also be written) * Link to/Upload a video pitch that highlights the economic impact of your business concept to our local economy by receiving an award. This can include goals for job creation, contributions to the local business tax base, increased physical presence of business operations, etc. Submission may also be written. Word count limit is 1000.
