Program Application
Thank you for your interest in attending CO.STARTERS at Southern Middle Tennessee Entrepreneur Centers (SMTEC)!

Whether you’re an owner of an existing business, or you are simply exploring a start-up concept, you are welcome to apply! You will need a well-articulated description of the product or service you offer (or plan on offering) as well as a description of your consumer, client, or target audience. Brevity and clarity are appreciated!

Tell us about you.
Name
Your answer
Last Name
Your answer
Street Address
Your answer
Home Phone
Your answer
Business Phone
Your answer
Cell Phone
Your answer
Email
Your answer
Annual Household Income
Answering this question and the next question will determine the amount of a possible discount.
Your answer
Number of people in household
Your answer
Date of Birth
Your answer
Gender
Race/Ethnicity
Please select one of the following.
What is your current work status?
What day of the week works best for you?
6-9 PM
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Why do you think you'd be a good candidate for CO.STARTERS?
Your answer
Tell us about your business/idea.
Business Concept
Please provide a well-articulated description of the product or service you offer (or plan on offering) and a description of your consumer, client, or target audience. Brevity and clarity are apprecitaed!
Your answer
Have you already launched the business that you'd like to explore through CO.STARTERS?
Business Name
If you answered yes to the question above, please tell us about your business in the next few questions.
Your answer
Type of business
Employees
Including yourself, how many employees do you currently have?
Your answer
How did you find us?
I do hereby give permission to Southern Middle Tennessee Entrepreneur Centers (SMTEC) and CO.STARTERS, its agents, and others working under its authority, full and free use of video/photographs containing my image/likeness. I understand these images may be used for promotional, news, research and/or educational purposes. I hereby release, discharge, and hold harmless SMTEC and its agents from any and all claims, demands, or causes of action that I may hereafter have by reason of anything contained in the photographs or video. I do further certify that I am either of legal age, or possess full legal capacity to execute the foregoing authorization and release.
Required
I understand that Southern Middle Tennessee Entrepreneur Centers (SMTEC) does not guarantee that I will be successful in my business. Furthermore, the benefits gained from participating in CO.STARTERS are a result of time, energy and dedication to the training program, and thus are not based solely on the completion of the coursework. I further understand and authorize SMTEC to provide applicable information to the assigned management counselor(s). I understand that any information released to be held in strict confidence by him/her. No person will be excluded from participation in or otherwise subjected to discrimination in regard to services, programs and employment provided by the SMTEC based on race, sex, color, national origin, sexual orientation, disability, age or religion.
Required
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