The Business Center Healthcare & Beauty Accelerator Program Application
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Business Email Address *
Business Owner First Name *
Business Owner Last Name *
Phone Number *
Gender *
Ethnicity *
How did you hear about us? *
Income level *
Do you consider yourself a healthcare, beauty or wellness brand? *
Healthcare / Beauty / Wellness Business Name *
Healthcare / Beauty / Wellness Business Address *
Healthcare / Beauty / Wellness Business City, State ZIP *
What year did you start your business? *
What is your company registration? *
What is our business lifecycle stage? *
Please list your social media handles for your business. If none, enter none. *
What services and/or products does your business offer? *
Does your business have a specialty niche? *
If yes, what is your specialty niche?
How many employees do you have? *
On average, how many customers do you service per month? *
Do you use a customer management system for the following? (please select all applicable) *
Required
What is your product classification? *
Required
What is your average customer sale? *
What platform(s) do you use to sell your products and/or services? *
Do you have a business plan? *
Do you have an accountant? *
Have you completed any training or continuing education in any of the following areas in the last year? (select all that apply)
Can you provide 2 years of business and personal tax returns? *
Required
Why do you want to participate in the health and beauty accelerator program? *
What knowledge do you hope to gain in participating in the Healthcare and Beauty Accelerator program? *
Please list three professional or vendor references. (Please be sure to include Name, Email Address, and Phone Number, and your relationship with the reference)  *
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