Application - New Mexico Community Capital (NMCC)

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Application

If you would like a pdf application sent to you via email or regular mail, please send an email to info@nmccap.org.

Step 1 of 5

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Part 1 - Candidate Information
Name*
Prefix First Middle Last Suffix
Mailing Address*
Street Address City State ZIP Code
Email*
Primary Phone Number*
Primary Number Type*
Alternative Phone Number*
Alternative Number Type*
American Indian Tribal Affiliation*
Employer (if applicable)
Emergency Contact Name*
Emergency Contact Relationship*
Emergency Contact Mobile Phone*
Emergency Contact Home Phone*

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Part 2 - Company Information
Is your company currently pre-venture (dream stage), in early stage/start up, or established and growing?*
If your company is established, answer the questions below. If your company is in the pre-venture or start-up stage, answer what your vision for the company is.
Company Name*
Website
Industry*
Corporate Structure*
Management Structure*
Annual Revenue*
Number of employees estimated 5 years in the future*
Ownership Percentage*
Number of employees currently employed or at start-up*
One Sentence Pitch*
Business Summary*
Problem solved or need addressed by business*
Description of Product or Service*
Target Market*
Marketing Strategy*
Competitors*
Competitive Advantage*

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Part 3 - Self Assessment
Self-rating of Knowledge and Understanding of Enterprise Development

I consider myself to possess the following degrees of knowledge/understanding of the subjects listed below (5 represents very knowledgeable, 0 represents no knowledge):
Entrepreneurs in American Economy*
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Market Analysis*
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Feasability Analysis*
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Developing a Business Plan*
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Goal Setting*
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Team Building & Organizational Development*
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Management*
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Small Business Technical & Financial Resources*
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Sales and Pricing Strategy*
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8-A Certification Requirements*
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E-commerce, Internet Sales*
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Native Art, Dance, Theatre, etc. as a Business*
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Self-rating of Candidates Qualifications

I consider myself to possess the following degrees of leadership attributes: (5 represents high degree, 0 represents low degree):
Winning Attitude*
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Good Verbal Communication Skills*
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Desire to Learn*
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Mental Stamina*
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Alertness*
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Flexibility*
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Confidence*
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Cheerful, Positive Personality*
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Considerate of Others*
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Good Physical Condition*
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Motivation to Be Successful, to Make a Profit*
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Willingness to Take a Calculated Risk*
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Part 4 - Candidate's Purpose for Attending the Training
This part requires written statements by the candidates that indicate your reasons for applying, the field in which you wish to start a business, the benefits expected to be gained from this training program and your prior training in enterprise development related subjects. These written statements will also be used to identify training needs and background factors that relate to these needs and will be important criteria used in the final selection.
Describe your reasons for applying to the Native Entrepreneur in Residence Program.*
Indicate the Field in which you wish to start a business, your background and/or experience in this particular field, and your reasons for starting this type of business.*
Describe the Skills you expect to acquire and how the Native Entrepreneur in Residence Program will enhance your ability to plan and manage a small business.*
List prior training in which you have participated, focusing on entrepreneurship or economic development or in a related field during the past five (5) years.*

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Part 5 - Certification
Please enter your initials for each item below.
I hereby certify that the information contained in this application is accurate to the best of my knowledge.*
I understand that this application will only be considered if it is complete and submitted by specified due date.*
I understand that I will be required to participate in Native Entrepreneur in Residence Program intake / eligibility process, which includes but is not limited to verification of American Indian heritage, income, and selective service registration (if male).*
I understand that, if selected, I will be required to submit a statement from my physician / medical provider if special accommodations are needed.*
I understand that I will be required to attend four (4) sessions and the New Mexico Community Capital will make all travel arrangements and pay for associated expenses, if needed, for ELIGIBLE program participants in accordance with federal travel regulations; if I am NOT eligible, <u>I may still attend training if selected</u> but will need to use non-NMCC financial resources for travel expenses and a fee may apply.*
Enter your full name in the box below*
Today's Date*
MM slash DD slash YYYY

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Contact Us

301 Gold Ave SW Suite 102, Albuquerque, NM 87102

Office 505.924.2820
E-mail: info@nmccap.org

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