LEAP Program Application

Contact Information

First Name

Last Name

Mailing Address

Mailing City

Mailing State

Mailing Zip Code

Is Your Business Address the Same as Your Mailing Address?

YesNo

Business Address

Business City

Business State

Business Zip Code

Phone Number

Phone: Home or Business?

HomeBusiness

Email

Email: Home or Business?

HomeBusiness

This course is designed to offer opportunities for diverse business owners, particularly those representing populations who have historically been discriminated against based on race, ethnicity, sexual preference, and disability status. The following demographic questions help determine the diversity of the program cohort. This personal identity information will be kept private within the South Carolina Community Loan Fund database. Answers to the following questions will remain anonymous when reporting statistics for grant purposes.

Not listed race

Self described gender

Are you a veteran?

YesNo

Do you consider yourself a member of the Lesbian, Gay, Bisexual, and/or Transgender (LGBT) community?

YesNoNo, but I identify as an AllyPrefer not to say

Do you have a disability?

YesNo

Is more than one person working on your business?

YesNo

List other group members

Are you able to devote four or more hours a week to this program?

YesNo

Please specify how you heard about LEAP

Project Information

Please note, this information will be kept confidential

Name of Your Company

This is the business that you will be working on throughout the duration of the course

Have you ever participated in entrepreneur classes in the past?

YesNo

Was it an SCCLF Program?

YesNoHave participated in both SCCLF Programs and other programs

Name of other entrepreneur classes

What stage is your progress in?

For existing or expanding companies

How long has your business been in operation?

Number of Employees

Annual Revenue:

Is this business currently your primary source of income?

YesNo

How many hours per week do you currently spend working on this business?

For ideas or start up companies

Number of Employees:

Have you raised any money for your idea? If so, from whom and how much?

Have you already prepared a business plan or any part of a business plan for this business?

YesNo

Supplemental Information

Please describe the business that you will be working on during the program in 1,000 words or less (250 word minimum). Your write-up should:
-Explain your business model or concept
-Describe how you serve/employ low to moderate-income individuals or communities
-Break down how would you use the capital funding investment of $30,000

Participation Agreement

I understand that if I am selected for participation in SCCLF's LEAP Program, I am

committing to:

I agree to attend and actively participate in the 10 week LEAP course. I will engage in the online curriculum and utilize my video and audio settings to contribute to class.
Meeting all submission deadlines. Participating fully in the program outside of class time, including writing a full business plan. Responding to all email and phone communication from South Carolina Community Loan Fund (SCCLF) and other partners in a timely manner.
I also understand that if I am awarded the seed capital, it will be disbursed based on agreed upon benchmarks set with SCCLF staff.
If awarded the allocated funds for the LEAP Program, I agree to have an active business bank account in order for the funds to be disbursed.
Further, I understand that in order to receive a loan from SCCLF for this project, I must go through the standard application and underwriting process.

Yes

The “Submit” button will finalize and process your application. Please make sure to review your application before hitting "Submit." After clicking submit you will be taken to an E-signature screen to verify all the information provided in this form. Upon signing you will receive an email notification you will have to click to verify your signature. Once that is received, you should receive an additional email confirming your submission.

I have read the above statement on how to submit my application