Application for TOP GUN

If you're one of Maine's top entrepreneurs, you should be part of Top Gun! Please fill out these questions, and a panel of advisers will review your application. Some applicants will then be asked for an interview (by phone or in person), and a few will be chosen for the 2011-12 classes in Portland and Bangor. The application deadline is July 15, 2011.

Individual Name: *

Company Name: *

Address 1: *

Address 2:

City: *

State: * - Select -AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming

Zip Code: *

Phone: *

Email Address: *

Which class location(s) will work for you?: *

Portland

Bangor

Rockland (if available)

Legal Structure: *

Corporation

Limited Liability Company

Sole Proprietorship

Other (please describe)

Other:

Company URL:

Provide a brief summary (150 words or less) of your company/product/idea:

What stage are you in development of your venture (how many years in existence, size of company, revenue, etc.)?:

Do you have any previous experience as an entrepreneur or with an entrepreneurial venture? If yes, please explain this experience:

Please list and explain three strengths and three areas for improvement for yourself as an entrepreneur:

Leadership Team - Please tell us in one or two sentences about something impressive that each founder has built or achieved; attach bio's describing entrepreneurial, business, or industry experience:

Bios:

If you have more than one, please add them all to a zip file and submit the zip file.

How much cash (not sweat equity) have you and/or others invested in this idea/business to date?:

What challenges are you facing or about to face with your venture?:

Five year from now, if you are successful, how many employees will your company have?:

1-2 employees

3-5 employees

6-10 employees

11-25 employees

26-50 employees

50+ employees

How did you hear about Top Gun?: - None -Business referralPersonal ReferralE-mail NewsletterEventSearch EngineWeb sitePrint mediaMCED meetingOther

Please be specific:

Why are you interested in the Top Gun program?:

What goals do you hope to achieve by participating in the program? :

What specific business assistance are you interested in obtaining?:

How will the Top Gun program benefit by having you as a participant?:

Reference(s):

Application Checklist: *

Resumes or bios of the management team and owners

Completed Application

Anything else you feel would be relevant to your application

Understanding of Expectations

There are key expectations that participants must acknowledge and agree to prior to approval for participation. These exist to ensure a greater level of success for the participants, mentors and the program in general. Please indicate agreement next to each.

Understanding of Expectations:

I will actively participate in Top Gun related activities (90%+ of scheduled events).

I am open to advice from mentors and recognize personal responsibility for taking action based on that advice.

I will join a statewide entrepreneurial community.

My business intends to remain Maine based.

Agreement: *

I have read and agree to the key expectations of the Applied Entrepreneurship Program Application Process.