Application | CO.STARTERS Core at [Organization]
Thank you for your interest in the CO.STARTERS Core program! We're excited to walk alongside you in your entrepreneurship journey.

Please fill out the following application.
Email *
First Name: *
Last Name: *
What is your mailing address? *
Postal Code
Mobile Phone
Sex
Clear selection
Race/Ethnicity
Have you ever served in the Military?
Clear selection
Do you have a physical or mental impairment which substantially limits you in one or more major life activity; or have a record of having such an impairment; or are regarded as having such an impairment?
Clear selection
Age Group
Highest level of education completed
Clear selection
Employed
Annual Household Income
Number of people in your household
Type of venture you anticipate working on
Tell us a little about your venture.
What will it be? Who will be your customer? What are you selling?
Stage of venture
How do you plan to work within this venture?
Clear selection
Business Name *
If you haven't decided on a name yet, type "Still working on it."
Business Website:
When are you available for Training?
Have you had any previous entrepreneurship training?
Clear selection
If yes, what time of training have you received?
Clear selection
What are you hoping to get out of this program? *
Help with marketing? Raising capital? Peers to bounce ideas off of? Accountability? These and more are all great answers!
How did you hear about this program? *
Agreement & Photo Release *
ProGeny Place may record or photograph all or some of the training course we provide. The goal of ProGeny Place is to “Move People to Middle Income”, by offering training and business support services.This release (the “Release”) will serve as our agreement concerning your participation at our training sessions. In consideration of your privacy, ProGeny would like to inform you that by completing this document and clicking “I agree” you are providing ProGeny Place with the right to record, stream, film and photograph your likeness at ProGeny events (the “Presentation”) and to distribute, broadcast, edit, translate (as discussed below) or otherwise disseminate it, without any further approval from you, in whole or in part, throughout the world, in perpetuity, in any and all media now known or hereafter developed. This agreement grants permission for ProGeny Place, but is not limited to, the right to use the Presentation either alone or together with supporting information, such as your name, voice, photograph, likeness and biographical data (collectively, “Supporting Information”). In addition, you understand and agree that ProGeny Place is not obligated to use the Presentation or Supporting Information in any way; (ii) you won’t receive any form of payment in connection with the use of the Presentation and/or Supporting Information; and (iii) you may not revoke the rights granted in this Release.
Thank you!
Thank you for your response. We will review your application and contact you with a decision as soon as we can.
A copy of your responses will be emailed to the address you provided.
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