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City:
*
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State:
*
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Zip Code:
*
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Company Phone: * Phone format should
be in XXX-XXX-XXXX
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Company Email Address:
Ex: email@email.com
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Company Website:
(If applicable) Ex: www.xxxxx.com or www.xxx.xxx.xx or www.xxx.xxx.xx
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Is your company based in your home?
*
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Do you work full-time in the business?
*
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Business Sector or Industry?
*
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What are the total number of employees that work for the business?
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Full-Time
*
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Part-Time
*
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Is your company certified as an M/WBE with the City of New York?
*
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If no, please note that in order to participate in this program, your company needs
to apply for and be certified as an M/WBE with the City of New York.
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Has your company applied for M/WBE certification?
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(To learn how to apply for M/WBE certification, go to www.nyc.gov/getcertified
Failure to obtain certification by the start date of the program will result in
ineligibility.)
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Does your company possess the proper licenses and permits to operate
in the City of New York?
*
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We are encouraging you to complete this CAP Corporate Coaching Program application,
however, you will need to apply for M/WBE certification.
To find out more information regarding licenses and permits, please go to NYC Business Express
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What are your annual gross revenues for the years indicated? If the year is not applicable to your company, please write N/A.
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Proof of company revenue must be provided prior to acceptance into program.
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Section 2: Applicant Information
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First Name:
*
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Last Name:
*
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Social Security Number:
(last 4 digits only)
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Gender:
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Title/Position in the Company:
*
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% of Ownership:
*
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Home Address: *
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City:
*
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State:
*
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Zip Code:
*
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Applicant Phone:
*
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Applicant Email:
*
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Section 3: Work History
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Are you a citizen of the United States and/or legally allowed to work in the
United States?
*
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How many years of prior experience do you have in the business sector
that your company operates in?
*
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Are you planning to start another business within the next twelve months?
*
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Please list your employment history:
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How many years have you owned the business?
*
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Describe product(s)/service(s) you sell.
*
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1500 characters remaining
on your input limit
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Please describe your customer(s) (size, geographic, consumer versus business, target demographic).
*
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1500 characters remaining
on your input limit
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What are the two most pressing issues currently facing your business
*
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1500 characters remaining
on your input limit
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Please indicate how this coaching would benefit your business. *
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1500 characters remaining
on your input limit
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What are the key strengths you can contribute to the program and your fellow participants? *
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1500 characters remaining
on your input limit
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What 3 major goals are you looking to accomplish this year for your business? *
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1500 characters remaining
on your input limit
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What top traits/characteristics are you looking for in a professional coach? *
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1500 characters remaining
on your input limit
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Have you created a business plan for your business?
*
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Section 4: Additional Information
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Are any of the principals of your company affiliated with the NYC
Department of Small Business Services (SBS) or work for/with any
organization that holds a contract that is managed by the NYC Department
of Small Business Services?
*
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If yes, please indicate:
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How were you referred to CAP Corporate Coaching Program?
*
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For fee information and program details please go to http://www.nyc.gov/html/sbs/nycbiz/html/summary/cap_info.shtml
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An email confirmation acknowledging receipt of your application will be sent to the applicant
email address when you hit “Submit”
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