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* 1. First + Last Name:

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* 2. Email Address:

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* 3. Phone Number:

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* 4. Street Address:

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* 5. City:

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* 6. Postal Code:

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* 7. Business Name:

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* 8. Is your business in operation?

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* 9. If yes, business start date:

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* 10. Business Address (if different than above):

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* 11. Business Website:

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* 12. Business Social Media Accounts:

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* 13. Provide a brief overview of the business:

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* 14. Provide a brief description of how your product or service is different from those in your industry

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* 15. Application Type:

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* 16. Amount Requested from Starter Company Plus:
(max $5,000)

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* 17. Grant money to be used for:

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* 18. How did you hear about Starter Company Plus?

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* 19. Please check all that apply to confirm your eligibility in the Starter Company Plus Program:

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* 20. Please check all that apply to confirm you understand some of the Starter Company Plus requirements. Additional information can be found at: www.regionalbusiness.ca/startercompanyplus

Notice of Collection

The information collected in this application will be used to determine eligibility and invite eligible candidates to proceed to the next stage of the competitive application process for the Starter Company Plus Program.

The personal information on this application is collected under the authority of sections 10 and 227 of the Municipal Act, 2001 for the purpose of administering the Starter Company Plus Program and selecting applicants. Questions about the collection of this personal information may be directed to the Business Development Officer - Entrepreneurship, Greater Sudbury Economic Development, Tom Davies Square, P.O. Box 5000 SNT A, 200 Brady Street, Sudbury, ON, P3A 5P3 or by telephoning 705-674-4455 ext 2482.

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