ENTREPRENEURIAL TRAINING PROGRAM APPLICATION FORM The PACE Entrepreneurial Training Program is a 36 hour, 6 week evening program, currently taught 6-8 PM, designed for start-ups and fledgling businesses. Coursework includes instruction in the fundamentals of small business, your business idea, qualifications you need to be a small business owner, business plan development and implementation, marketing, bookkeeping and record keeping, financing and financial forms, small business practices and legal aspects of business. Graduates receive a certificate of completion. Qualified graduates will receive one-on-one technical assistance from PACE BDC Business Counselors. Please fill in the form below. All fields required. If "not applicable" indicate 'NA' First Name: Last Name: Street Address: Apt/Ste No.: City: State: Choose a State Alaska Alabama Arkansas Arizona California Colorado Connecticut District of Columbia Delaware Florida Georgia Hawaii Iowa Idaho Illinois Indiana Kansas Kentucky Louisiana Massachusetts Maryland Maine Michigan Minnesota Missouri Mississippi Montana North Carolina North Dakota Nebraska New Hampshire New Jersey New Mexico Nevada New York Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Virginia Vermont Washington Wisconsin West Virginia Wyoming Zip: Email: Phone No.: Fax No.: Message Phone:     Family Income during the past 12 months: $ Source of Income: Ethnic Group: Choose below: Asian Hispanic African American Caucasian Filipino Other     Other (Specify): Please list any business training courses attended: Type here Please describe what stage your business is in: Choose Below: Just an idea Have done some business informally Have formally established a business Please describe your business idea: Type here What work or managerial experience do you have in the business arena you have chosen? Choose Below: None 1-3 years Over 3 years Where do you plan to obtain the major funding for your business idea? Choose Below: Self/immediate family Friends/contacts Financial Institutions Have you ever been in business for yourself? Yes No Describe type of business and time involved: Type here Where did you hear about this program? Choose Below: From a Friend Word of Mouth Newspaper Magazine Search Engine Non-profit Organization Public Service Announcement Others If Others, please specify: If accepted into the program, will you be able to regularly attend evening classes from 6-8 PM for 6 weeks? Yes No (Press Once Only) "We Bring Solutions to your Business!"