E3 Intake Form

The purpose of this intake form is to allow us to learn about you and your business. The questions were developed to help us understand where you are within your entrepreneurial journey so that we can provide the best recommendations for resources and support to help you reach your entrepreneurial goals. PDFF supports entrepreneurs and businesses at every stage. Please answer truthfully.

Name(Required)
Preferred Method of Contact(Required)
0 of 200 max characters
Business Address(Required)
Are you the owner of this business?(Required)

Business Information

The following questions allow us to understand where you are within your entrepreneurial journey, whether that be the conceptual, emerging, stable or accelerated stage. PDFF supports entrepreneurs and businesses at every stage. Please answer truthfully.
Self-Identified Entrepreneurial Stage(Required)
Self-identify where you think you are within your entrepreneurial journey. PDFF is equipped to support entrepreneurs and businesses at every stage. This information helps us understand your business so that we can appropriately review your application and provide you with the best resources and support.
0 of 750 max characters
Tell us about your business. Give a brief, high level description of what your business is about and what products or services you offer.
Business License(Required)
Do you have a valid business license?
Areas Served(Required)
What areas do you serve? Select all that apply.
What is the structure of your business? Select one.
Industry(Required)
Select the best answer that applies.
Business Plan(Required)
Do you have a current business plan?
Market Analysis(Required)
Have you conducted a market analysis?

Revenue & Funding

Our goal is to help you increase your revenue. We ask for this data to help us assess where you are and how we can help you grow. Please answer truthfully.
Our goal is to help you increase your revenue. We ask for this data to help us assess where you are and how we can help you grow. Please answer truthfully.
Our goal is to help you increase your revenue. We ask for this data to help us assess where you are and how we can help you grow. Please answer truthfully.
0 of 500 max characters
Enter NA if not applicable.
Grant Funding(Required)
Have you applied and/or received any grant funding?
0 of 500 max characters
Enter NA if not applicable.
Loans(Required)
Have you received any loans for business operations?
Business Growth Challenges(Required)
Select all that apply.
0 of 500 max characters
0 of 500 max characters
What do you hope to gain from joining E3? Specify the services and type of support you are most interested in receiving.

Organizational Structure

0 of 750 max characters
Full-time Founder(Required)
Is this business your primary source of income?
Leadership Structure(Required)
Board of Directors(Required)
Does your business have a board of directors?
Financial Support(Required)
Does your business have an accountant?
Legal Support(Required)
Do you have an attorney for your business?

Existing Relationships

PDFF partners with many organizations across the entrepreneurial landscape. It is helpful to know who you are already working with so we can make the most appropriate recommendations to best support your growth.
Existing Relationships(Required)
Are you currently working with any organizations, consultants, service providers or participating in other accelerator programs?
0 of 500 max characters
Enter NA if not applicable.

Social, Environmental & Workforce Impact

We define “impact” as a function of both the number of people or communities who will benefit from your business services and the magnitude of the benefit that will yield.
Social, Environmental and/or Workforce Impact(Required)
Does your business incorporate social, environmental and/or workforce impact in its business model?
Select the best answer that applies.
Workforce Growth Potential
How many new employment opportunities will your business create within the next three years?

Demographic Information

E3 was created to be welcoming and inclusive. The first step to inclusivity is data collection. Some of the questions asked within this section are required for data collection purposes and will not affect your eligibility to move forward.
Ethnicity
Low-to-moderate-income Status
Is your total household income under $58k per year? We ask this question specifically on behalf of our funding partners to report on the percentage of individuals who classify as low to moderate income (LMI) persons. Your answer will be kept confidential.
How did you hear about us?
Newsletter & Emails
Consent
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