Your name (business founder)*Name of person filling this out (should be a founder of the business) First Last Name of additional founderList a second founder, if any. First Last Name of additional founderList a third founder, if any. List any additional founders in the business description field, below. First Last Name of the business*If the business has no name yet, please enter a working title.AddressWhere the business is located and receives mail. Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Best phone number*Additional phone number, if anyEmail address* Website URLYour business website address, if availableBusiness Description*In one brief paragraph, please describe your business. Please mention when it was founded, and include any pivots you have made. What is your big dream for your business?*If you look out 5 or 10 years and everything went perfect, how would your life and your business look? Social mission, if any?*Does your business have a social mission and how is that played out or integrated into your business? A social mission is not required to be in the program, but you have one we want to know so we can help you meet it. What problem are you solving for your customers?* Is this business currently operating?*In other words, do you have an existing business that is already selling products and/or services to real customers (not just your mom and friends)? Yes No What do you sell in your business?*Please describe the product(s) or service(s) you are selling. Who are you selling to, and how?*Who are your customers? Are you selling direct to clients or through dealerships / distributors / retailers? Explain your current sales model. Also, if you would like to move into other sales models to help grow your business, what are they? Monthly revenue*What is your current monthly revenue? Has your monthly revenue been consistent at this level for at least three months or are your revenues up and down? There is no right answer. Knowing what is happening will help us help you. Employees*Do you have employees? If so how many are full time and how many are part time? (Do NOT include the owners/founders in this employee count) Owner/founder participation*Are the owner(s) / founder(s) currently working full or part-time on the business? Full time commitment during Windham Grows*If accepted into the Windham Grows program, can at least one of the founders work full-time in the business? This is a requirement to be accepted into the program. Yes No What do you need?*What are the most important needs you have as a business owner? What would you like to get out of the program?*