First Name
Last Name
Business Name
What industry is your business in?
Please select...
Apparel - Manufacturing
Apparel - Retail
Architecture
Arts and Entertainment
Banking
Bars, Restaurants, Catering
Beauty and Personal Care
Cannabis
Construction
Consulting
Distribution and Logistics
Education
Energy
Engineering
Environmental
Event Planning
Financial Services
Food and Beverage
Food and Beverage - Manufacturing/CPG
Government
Healthcare
Hospitality
Insurance
Legal
Manufacturing
Marketing and Communications
Multimedia and Publishing
Nonprofit
Personal Services - Commercial
Professional Services - Personal
Professional Service - Residential
Real Estate
Recreation
Retail
Technology
Transportation
Utilities
Other
Website
Email
Phone number
Best way to reach you:
Email
Phone
Text
Street Address
City
Zip code
2019 Revenue:
2020 Revenue:
Is your business profitable?
Yes
No
How much capital are you seeking?
(from ICA)
How much capital have you raised to date?
(from all sources)
What's your capital raise timeline?
ASAP (within 1 month)
3 months
6 months
6+ months
I'm not sure
Think of your ideal scenario.
How do you plan to use the funds you raise?
Which ICA program have you completed?
Please select...
The Lab at ICA
The Accelerator at ICA
The Resilience Lab Accelerator
Growth Strategies
I've received investment from Fund Good Jobs
I am a Rapid Response Liquidity Fund (RRLF) loan recipient
I have NOT completed any ICA programs.
Please select all that apply.
When was the most recent program you completed?
Anything else we should know or you'd like to share?