Become a Member

Basic Membership Special = $25 per month (paid in quarterly allotments) = $75
Premium Membership Special = $500

Member Levels

First Name* Last Name*
Business Name    
Email* Phone Number*


Street Address Street Address line 2
City State / Province
Age Range Employment Status(do you currently have a job not related to your business?)
If so, Where? Business Start Date (officially started, plan to start)
Business Type (Sole Proprietorship, LLC, Incorporated, LLP, other)
My business will do/does the following:
Why have you started this business, what need will it address?
Why would people buy your products and services, how are they unique?
How will you find these customers? What will you do to get them to buy from you?
Who are your main competitors?
What skills, experience or training do you have that help operate your business?
How much funding will be required to start and or operate your business and where would it come from and what will it be used for?
If a new business, what are some of the challenges you have faced getting started?
If you have already started, what areas do you need technical assistance in?
What steps have you taken to rectify these challenges?
Provide the names of other owners, if any
What is your Domain Name?: (if different from your current web address above, a registered domain name example;, if any Date Of Birth
List Foreign Languages that you speak
Profile: Along with your photo, please provide a brief two paragraph description of you and your business.
Upload Your Photo:

Business Status and Goals

Customers: How many do you have now?  0-20 21-100 100 or More Unknown
Social Media Reach: Which do you use? Check all that apply.  Facebook Twitter Youtube Instagram Linkedin Blogs
Revenue: Are you earning money now? If so, what are your Year to Date Sales?
What would you like to experience in the incubator? (see User Experience Map)  1-3 Months 3-6 Months 6-12 Months
What is/are your one year business goal(s)?
How will you use the assistance offered in the accelerator to accomplish your business goal(s)?
I have employees  Yes No I am family owned  Yes No
I have a Patent granted/Patent Pending/ Trademarked  Yes No I have sales sheets  Yes No
I have samples  Yes No I have a business license  Yes No
I have product liability insurance  Yes No I have a UPC  Yes No
I have packaging  Yes No I have a business Card  Yes No
I have a PayPal account  Yes No I use E-commerce Sites to sale my products (Amazon, EBay, Google, Shopify)  Yes No

Terms and Conditions

 By submitting this form you agree the Member’s Terms and Conditions.


Please fill the above text*