BUILD Application | City of Little Rock

Name *

Email *

Comment *

Consent for storing submitted data *

Yes, I give permission to store and process my data
No, I don't consent to storing and processing my data

What is your primary language? *

English
Spanish
Other

Legal business name *

Business type/industry *

If you answered other to the previous question, please specify.

⦁ Doing business as (DBA) *

Business owner’s first and last name *

Business owner’s email address *

Business owner’s home address *

Business owner’s home telephone number *

Business owner’s cell phone number *

Is this a minority or woman-owned business? *

Yes
No

Is this business certified by the State of Arkansas as a Minority or Woman-Owned Business Enterprise (MWBE)? *

Yes
No

Physical Business Address *

Business Mailing Address *

Business Phone Number *

Please provide a brief description of your business or business idea *

Why do you want to participate in this program? *

In what year did your business begin operations?

What is the legal entity of your business?

What percentage of the business do you own? *

What was your business revenue for 2021? *

Did your business make a profit in 2021? *

Did your business experience a loss in 2021? *

Do you work in the business? *

Yes
No

Number of full-time employees, including yourself? *

If selected for this program, I hereby pledge that I will make a good faith effort to attend the business academy classes through completion. *

Yes
No

I certify that I am the owner of the above-named small business and that my business meets the requirements for the Small Business Development Office (SBDO) – Businesses United In Leadership Development (BUILD) Program as *

N/A – I have an idea for a business but have not started
A for-profit micro-enterprise business (1-4 employees)
A for-profit small business (5-10 employees)

Signature of Applicant (TYPE YOUR NAME) By inputting your name below, the applicant certifies the information is true and accurate under pains and penalties of perjury. *

Businesses United In Leadership Development (BUILD) Program Application