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Providing investment capital that enables women to make a meaningful leap for their company’s growth.
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Applicant Information
Applicant Name
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Position
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Home Mailing Address
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Street Address
City
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Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
ZIP Code
Cell Phone Number
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Home Phone Number
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Email Address
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Business Information
Business Name
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Business Address
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Street Address
City
State
Alabama
Alaska
American Samoa
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
U.S. Virgin Islands
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
ZIP Code
Office Phone Number
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Extension
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Website
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Industry Type
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Describe Your Business (One Paragraph)
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State Your Value Proposition
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Full Time Employees
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Part Time Employees
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Years in Operation
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Who are your target customers?
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Who are your main competitors
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What differentiates you from your competitors
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Capital Needs
How much capital are you seeking?
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What would you do with the capital?
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How much capital has been invested in the company? Please check all sources of capital and list amounts.
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Your Personal Funds
Your Personal Funds
Personal Funds Amount
Friends/Family
Friends/Family
Friends/Family Amount
Bank Loans
Bank Loans
Bank Loans Amount
Grants
Grants
Grants Amount
Venture Capital
Venture Capital
Venture Capital Amount
Other
Other
Other Amount
Does anyone else have ownership equity in your company? If so, please list who and how much.
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Lifetime Sales
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Gross Income in 2021
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Net Income in 2021
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YTD 2022 Sales
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Projected 2022 Sales
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What are your biggest challenges
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What are the greatest opportunities in your industry?
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If you received the requested capital, describe what your company would look like in three years?
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INQUIRIES
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443.278.9321