SEG Master Application for Services
Thank you for your interest in Social Enterprise Greenhouse.

We look forward to hearing more about your ideas!

The first part of this application asks for general information and can be completed quickly.

The second part may take longer (30-60 minutes), especially for the SEG Accelerator Program. (Note that answers are not auto-saved so we suggest saving everything in a word document as you write).

If you need help with any part of this application please contact us at info@segreenhouse.org.

Do well, do good!

Email address *
First Name, Last Name *
Your answer
Position Title *
If not applicable, please answer N/A
Your answer
Home Address
Street *
Your answer
City/Town *
Your answer
State *
Zip Code *
Your answer
Telephone *
Your answer
Email *
Your answer
Basic Venture Information
Name of Venture *
If the venture does not currently have a name please answer N/A
Your answer
Venture Address
Street
Your answer
City/Town
Your answer
State
Zip Code
Your answer
Telephone
Your answer
Email
Your answer
Where does/will your venture operate? *
Country, Region, and/or City (Where is the primary locale of sales, clients, and beneficiaries of your venture)
Your answer
What is your industry? *
Please select all industries that apply:
Does your Venture fall into one of the industry clusters below? *
Required
Venture established in *
Please respond when you began actively working on your venture
MM
/
DD
/
YYYY
Number of Employees (Part-time, Full-time) *
ex. 10 (Part--Time), 6 (Full-time)
Your answer
Legal Structure *
Which best describes your venture? *
Does your business fit any of the following features? *
Please check all that apply to any individual in you leadership team (i.e CEO, co-founder, CFO, Partner)
Required
With which ethnic/racial group(s) do you most identify? *
Check all that apply.
Required
Annual Operating Budget *
Venture Stage *
Federal Tax ID (if incorporated)
Your answer
Mission *
The mission is a statement about why your venture exists
Your answer
What does your venture do? *
Elaborate on what you are doing, how you are doing it, and for which beneficiaries
Your answer
How does your venture 'do good' (ie. address social issues)? *
Your answer
Where is your geographic area of impact? *
If you are not yet operational please answer your planned geographic area of impact
Required
Who benefits from your venture's work? *
Please only select the primary groups which your venture specifically serves
Required
How did you hear about SEG? *
Have you been in contact with someone from SEG prior to filling out this form? *
If yes, with whom?
Your answer
In which of the following areas could your venture use support? *
Required
Which program are you submitting an application for? *
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