Start Up Downeast Application Form
  Admission is open to any WCCC student who meets the following criteria:
 - Meets income eligibility guidelines
 - Motivated to increase their education & find employment
 - Interested in learning how to start a business 

Initial Application Deadline: Rolling
Email *
Name *
Birthdate *
Physical Mailing Address *
Town *
E-mail Address *
Cell Phone Number *
Home Phone Number *
Work Phone Number *
What is the best place to reach you? *
Is it okay to Text you? *
Is it okay to Text you? *
Do you use Facebook Messenger? *
Is it okay to contact you by FB? *
Required
Current Marital Status? *
How did you hear about Start Up Downeast? *
I was referred to Start Up Downeast by:
Do you have children under 13?
Clear selection
Would you need childcare for them? (Include names/birthdate
Would you need childcare for them? (Include names/birthdate
Educational Information:
Are you currently enrolled at WCCC?
Clear selection
Do you have your high school diploma, GED or HiSet?
Clear selection
Do you have other degrees or training Certificates?
Clear selection
If so, please list:
Have you previously attended college or university classes?
Clear selection
If yes, where? (Please list colleges and dates)
Do you owe any money to any college or university?
Clear selection
If yes, where and how much do you owe?
Do you have any student loans that are in default?
Clear selection
Financial and Employment Information:
Do you participate in any of the following programs? (Check all that apply)
Are you legally eligible to work in the United States?
Are you currently working?
If so, how many hours per week?
Why do you want to attend Start Up Downeast? How do you think that this education will impact your life?
Start Up Downeast is focused on helping participants gain skills toward small business ownership. Please describe your small business goals, ideas, or what interests you about small business ownership. 
Please read the following statement and sign below:
  • The information in this application is true and correct to the best of my knowledge. I hereby grant permission to Family Futures Downeast to see the release of personal information concerning me from sources reported in this application including, but not limited to: government agencies, educational institutions, and health care providers.
Signature
Date
A copy of your responses will be emailed to .
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