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   North Attleborough Business Accelerator (NABA) Application

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4. What is your business name?*
5. Where is your business based/located?*
7. Name of the Primary Applicant*
9. Are you one of the founders of the organization?

   1. Yes
   2. No
10. Are you the decision maker in the organization?*

    1. I am not the lead decision maker
    2. I share decision making with another person
14. Primary Applicant Information
16. First Name*
17. Last Name*
19. Address*
21. City*
22. State*
23. Zip Code*
25. Phone Number*
26. Email Address*
28. Applicant Title*
29. Your Time Commitment

    1. Full Time
    2. Part Time
31. Executive Summary - Please attach*
32. Pitch Deck - Please Attach*
36. Organization Information
38. Year Founded*
39. Number of Employees*
41. Organization Website
43. Tell us about your business and how it fits into the North Attleborough economic ecosystem (450 words or less)*
45. What do you want to achieve if selected for funding by NABA? (200 words or less)*
47. Is there anything else you want to share (200 words or less)*
51. Business Legal Structure*

    1. B-Corp
    2. C-Corp
    3. S-Corp
    4. LLC
    5. Sole Proprietor
52. With regard to your business what stage is your business in?*

    1. Idea
    2. Working Prototype
    3. Solid customer base/feedback in the market or on the way to market
    4. Scaling
54. 2022 Revenue*
    -- Select One --Under $25k/year$25k-$49k/year$50k-$99k/year$100k-$249k/year$250k or above/year
56. 2023 Revenue Estimate*
    -- Select One --Under $25k/year$25k-$49k/year$50k-$99k/year$100k-$249k/year$250k or above/year
58. Do you have a board of advisors?*

    1. Yes
    2. No
59. If yes, please provide the members of your board of advisors*
63. About You
65. What do you hope to gain personally from this initiative?*
67. How do you see yourself contributing to the North Attleborough community?*
69. Describe what you will do with the funding.*
71. What is your goal? In other words, how do you define success?*
73. Do you have any of the following social media accounts?*

    1. Linked-In
    2. Facebook
    3. Twitter
    4. Instagram
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75. 1. Receive an email copy of this form.
76. Email address

    This field is not part of the form submission.

77. Submit

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