Name
*
First Name
Last Name
Business Title
*
Official Company Name
*
Primary Telephone #
*
Country
(###)
###
####
Email
*
Business Address
*
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
What is your business primary services area?
*
Northen Texas
Southern Texas
Eastern Texas
West Texas
State of Texas
Outside of Texas
What is the legal structure of your business?
*
Sole Proprietorship
Limited Liability Company (LLC)
"C" Corporation
"S" Corporation
"B" Corporation
Nonprofit
Other
Is your business 51% or more owned by a female Veteran and/or military spouse?
Yes
No
What is your primary business industry?
*
Natural resources and mining
Construction
Manufacturing
Trade, transportation, and utilities
Information
Financial activities
Professional and business services
Education and health services
Leisure and hospitality
Other Services (except Public Administration)
Does your business have an approved System for Award Management (SAM) Registration
*
If selected you will be asked to provide proof of registration
Supplement Success Criteria
*
These are not required, but will add an extra advantage towards your businesses ability to be successful at federal contracting.
Military Assoication
What is/was the associated branch of service?
*
Air Force
Army
Coast Guard
Marines
Navy
Other
What is your current status (check all that apply)?
*
Note, Military dependents do not qualify for this specific program.
How many years did you or your spouse serve (Active Duty and Reserve combined)?
*
Less than 3 yrs.
3 to 5 years
5 to 7 years
7 to 10 years
10 to 15 years
15 to 20 years
20 to 25 years
25 to 30 years
More than 30 years
Demograhics
Age Range
*
Under 21
22-35
36-45
46-55
55-65
Over 65
Ethnicity
*
Hispanic Orgin
Non-Hispanic Orgin
Race
*
If mixed race, please select all that apply.
Business Intake Assessment
Identify from the selections below, if your business was or is being impacted by one or more of these issues due to COVID 19, please check all those that apply.
*
Please select the top five issues from the selection below that have directly impacted your business due to COVID 19.
*
From your previous answers, please provide a brief explanation of how COVID 19 has or is directly impacting your business in each area. Your explanation here will help us determine if you are a good candidate for this program.
*
Is your business your primary source of income?
*
Yes
No
Please identify what percentage of your revenues have been impacted due to COVID-19?
*
My business revenues have not been impacted
14% or less
15% - 20%
20% - 40%
40% - 60%
60% - 80%
80% - 100%
I'm unsure of the exact percentage of impact
Please identify the type of assistance you have applied for related to COVID-19? Check all those that apply.
*
Please identify to date, all the financial assistance you where able to secure related to COVID 19. Please share the sponsors and the amount in the following format; for example, EIDI $2000 Grant & $5000 Loan.
*
Please share if you have pivoted or repositioned your business due to COVID 19 and experienced any of these potentially positive impacts listed below? Check all those apply.
*
QUICK SWOT ANALYSIS
Please share your company's most relevant strength? This could include current leadership, a product/service or internal business system or processes.
*
Please share what you perceive as your company's greatest internal weakness? This could include current leadership, a product/service or internal business system or processes.
*
Please share what you perceive as your company's most relevant threat? This could include the current economy, competitors, industry ytrends, etc.
*
Please share what you perceive as your company's current opportunities? This could include the current economy, new industry trends, etc.
*
Do you currently have a business mentor?
*
Yes
No
If you answer yes to the previous questions, please identify your mentor association.
*
N/A
VWEC
SCORE
Bunker Labs
Women Business Center
Veteran Business Outreach Center
Another Free Mentorship Program
Fee-based Mentor/Coaching Service
REQUIRED SESSION AVAILABILITY
*
This is 14-day interactive intensive real world simulation, in which candidates will leave a completed/submited contract.
Please share any additional information you believe is relevant to your selection as a candidate for this program.
Required Vertification & Financial Documents
*
Ensure your business name is included with every document uploaded.
Woman Veteran/Female Military Spouse Verification Documentation
*
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Woman Veteran/Female Military Spouse Majority-Owned Business Verification Documentation
*
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Length of Time in Business Verification Documentation
*
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2018 or 2019 Tax Statement illustrating a minimum of $100k in revenues
*
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