DA Temp -

What best describes your interest in Cultivate? (Check all that apply)I am interested in resources to support the growth of my small businessMy business provides services to small businesses and I'd like to volunteer time to help them in my area of expertiseI'm interested in an office, coworking or business address plan at a Cultivate Business CenterI work for a company or organization that is interested in exploring collaborations with Cultivate to assist small businesses in my community

Have you previously met with a Cultivate Advisor? *I have not yet met with a Cultivate AdvisorYes with Matt YerkesYes with Elizabeth Willford

Please select the Ohio County where your business is located *The county where you are located will determine what services Cultivate can provide and connections that we refer to you.

Your Name *

Last Name *

Email Address *

Phone *

How did you hear about Cultivate?If you were referred by a colleague or organization tell us here.

Business Information

Business Name *

Website

Street Address *

Apartment, suite, etc

City

State

ZIP / Postal Code

Tell Us What Your Business Does

Business Owner Gender *MaleFemaleOtherI'd rather not say

What types of business trainings or videos are most interesting to you?Business Launching - Validate Your Idea, Create A Business Plan With Projections & Start The Launch ChecklistGrow Sales/Revenue - Create A Trust-Building Process To Continually Add New CustomersBusiness Finances - Improve Your Business Finances With A Budget & ForecastDigital Marketing - How to Create a Professional Business PresenceCheck all that interest you. Cultivate will send you a link for free access to our business trainings.

What are Cultivate referrals?

Cultivate will do our best to refer you to service providers for any of the business services that you select. These service providers volunteer a small amount of their time to provide you with a sales consultation to help you to understand the area of expertise that you select. They have agreed to correspond with you in a prompt and professional manner and Cultivate will email you a short survey to provide feedback on your interaction.

Small Business Advising, Coaching or SupportFree Small Business Development Center (SBDC can assist you with business plans, loans and business certifications)Free SCORE Mentoring (SCORE provides mentors at no cost that are matched to your business)Business Coach for established businesses. (free initial consultations but coaches charge for their ongoing services)Create a Professional Business Presence (address, website, business profiles)

Please select any of the Marketing Services for referralWebsite developmentGraphic design for logo, social media graphics or marketing collateralSocial media support to write and post contentPaid digital ad campaign setup and managementEmail marketing setup and campaignsMarketing strategy, writing and messagingGoogle business profile setup and contentHelp getting Google reviews & managing reviewscheck any areas that your business needs

Please select any Legal services for referralLegal entity setup and operating agreementsContracts, leases and customer agreementsTrademarks, patents or other intellectual propertycheck any areas that your business needs

Please select any Accounting services for referralCertified Professional Accountant/Tax professionalPayroll setup and processingBookkeepingcheck any areas that your business needs

Please select any Business Lending or Financial ServicesSmall business loanReceivable financingUnsecured business loans or line of creditSmall business coach to develop an investor pitchcheck any areas that your business needs

Please select any Business Insurance services for referralCommercial liabilityProfessional liabilityWorkmans compensationGroup health insurance (2 or more employees)Marketplace health insurance (individual plans)check any areas that your business needs

Please select any Networking or Community Involvement for referralLocal Chamber of CommerceNetworking group in my communitycheck any areas that your business needs

Detailed business description for your Cultivate Business ProfilePlease provide a description of how you can assist a small business with a free sales consultation. Help them to understand what your business does, why they would want to schedule this session with you. We will provide this to the business when we make the referral for you. If you would like to stipulate the length of the sales consultation or that they need to schedule this session in person, over zoom or with a booking link you provide then provide those details.

Facebook URL

LinkedIn URL

Booking URL

Instagram URL

Logo

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Head Shot of Primary Contact or Featured Images

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Business Assistance Provided With USDA Support

Cultivate can log our Technical Assistance support for your business towards our goals to serve Rural Entrepreneurs and may be able to provide additional support for your business thanks to the USDA.

RURAL BUSINESS DEVELOPMENT GRANT (RBDG) REQUIRED CERTIFICATIONS Rural Benefit Certification It is hereby certified that the project is located in a rural area and all activities provided under the grant will benefit a rural area. A “rural area” is any area that is outside the urbanized periphery of a city with a population in excess of 50,000 inhabitants, according to the latest decennial census of the United States. United States - Controlled Certification It is hereby certified that at least 51 percent of the outstanding interest in the project has membership or is owned by those who are either citizens of the United States or reside in the United States after being legally admitted for permanent residence. Small and Emerging Private Business Certification It is hereby certified that the business (or potential business) being assisted meets the “Small and Emerging Private Business” certification as “Any private business which will employ 50 or fewer new employees and has less than $1 million in projected gross revenues.

First Name *Signed By

Last Name

USDA Rural Eligible