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Momentum 360 Program Application

  1. Instructions
    Please fill out this form as completely as possible, and sign and date the bottom of the form. Incomplete or invalid information will not be processed.
  2. Part A: Business Information
  3. Are you already in business and being paid for your product or service?
  4. Part B: Additional Information
  5. Part C: Agreement and Signature
    Applicants must attend 6 weeks (once weekly) of a small business course held online via Zoom, so reliable access to a computer with Internet connection is required. Each class is 2 hours long and will be held on Thursday evenings 6:00 pm - 8:00 pm in Summer 2021. By submitting this form, I am agreeing that, if selected, I am able to attend 100% of these Thursday night classes.
  6. Type applicant initials.
  7. Receive an email copy of this form.
  8. This field is not part of the form submission.
  9. Leave This Blank:

  10. This field is not part of the form submission.