Apply to become an Elmseed member today!

• Name:
• Home Phone Number
• Cell Phone Number
• Email Address
• Home Address
• Business Address
• 1) Please check one
  
  I am applying to Elmseed because I hope to start a business
  
  I am applying to Elmseed as a current business owner
• 2) If you are a current business owner, please write a 1-2 paragraph description of your business. If you hope to start a business, please write a short description of your business idea.
  
  Type Here
• 3) Do you have a written business plan? Yes No
• 4) Do you have any previous business or work experience? Have you previously owned a business? Please describe.
  
  Type Here
• 5) What past business/work experience or training qualifies you to start/operate your current business/business idea?
  
  Type Here
• 6) If accepted as an Elmseed member, would you be interested in enrolling in an Elmseed business training course? Yes No
• 7) Are you a member of another business organization (i.e. Chamber of Commerce)? Have you previously enrolled in a business training course? Please describe below.
  
  Type Here
• 8) Why are you applying to Elmseed? What do you hope to gain from your Elmseed membership?
  
  Type Here
• Research Questions:
  
  These questions are for Elmseed research purposes only and will have no effect on the outcome of your application. The information you provide here helps us to better serve our clients. Your information is confidential and will not be shared with third parties. We thank you for your help.
  
  9) How did you hear about Elmseed?
  
  Type Here
• 10) What is your gender? Male Female
• 11) What is your ethnicity (African-American, White, Hispanic/Latino, Asian/Pacific Islander, Native American, Other: please describe)
  
  Type Here
• 12) Please estimate your family’s average annual income (total income from all earners): Less than $15,000 $15,001-$25,000 $25,001-$35,000 $35,001-$45,000 $45,001-$55,000 $55,001-$65,000 $65,001-$75,000 $75,001-$85,000 Over $85,000
• 13) What is your highest level of completed education?
  
  Some high school
  
  High school diploma
  
  Some college
  
  College degree
  
  Graduate degree
• Signature
• Date