HSBA Application

Section 1: Applicant Information

1.1. Business Name:

1.2. Business Address (Principal Place of Business in Henderson):

Address Line 1

Address Line 2

City

State

Zip Code

1.3. Business Structure (Sole Proprietorship, LLC, Partnership, Corporation)

Sole Proprietorship
LLC
Corporation

1.4 Applicants Name

First

Last

1.5 Title

1.6 Business Phone:

1.7 Email Address:

1.8 Website (if applicable):

Section 2: Business Overview

2.1. Type of Business (e.g., finance, marketing, e-commerce, etc.):

Finance
Marketing
E-Commerce
Other

2.2 Is your business a non-profit business?

Yes
No

2.3 Briefly describe your business (products, services, mission, etc.):

2.4 How many years has your business been operating in Henderson?

2.5 Annual Revenue (approximate):

Annual Revenue - 2020

Annual Revenue - 2021

Annual Revenue - 2022

2.6 How many employees do you have?

Full-Time Employee(s)

Part-Time Employee(s)

1099/Contractor(s)

2.7 Is your business minority-owned, woman-owned, or veteran-owned?

Yes
No

Section 3: Eligibility

3.1 Have your business generated at least $50,000 annually but not more than $700,000 in revenue in the past year?

Yes
No

3.2 Do you have a business plan?

Yes
No

3.3 Have you had your principal place of business in the City of Henderson for at least 2 years?

Yes
No

3.5 Please describe how your business actively engages with the local community or contributes to the betterment of the City of Henderson. This may include participation in community events, support for local charities, job creation, or any other activities that positively impact the city. (Max 200 words)

Section 4: Deserving Business Questions

4.1 Why do you believe your small business deserves to be selected for the Henderson Small Business Assistance Program? Please describe the unique qualities or circumstances that make your business stand out. (Max 300 words)

4.2 What specific challenges or opportunities do you see for your business that you hope to address with the assistance provided by the program? (Max 200 words)

4.3 Where do you see your business in the next 2-5 years, and how will the Henderson Small Business Assistance Program help you achieve those goals? (Max 200 words)

Section 5: Additional Information

5.1 Have you previously participated in any mentorship/consulting programs?

Yes
No

If you answered yes above, please provide details:

5.2 How did you hear about the HSBA Program?