Application for Habitat for Neighborhood Business

Habitat for Neighborhood Business is a non-profit organization affiliated with St. Louis, University that provides no-cost support to minority small business owners in the under-served areas of the city of St. Louis. Please complete the application for Habitat for Neighborhood Business answering all questions. Answer N/A if a question does not apply to your business. Before you begin to complete the application, check to see if your business is within HNB's service area in the City of St. Louis. HNB's service area is: Northern boundary in the city of St. Louis is Highway 70, eastern boundary is 12th street, southern boundary is Highway 44 and the city limits at Skinker is the western boundary. Businesses located within these boundaries are eligible for participation in the HNB program. Each person who is an owner of the business must complete a separate application which includes a credit and background check. You will also receive a link from DocuSign for your digital signature after you complete and return the application. On this application, just type in your name where it asks for your signature. **All information provided to HNB is confidential and will not be shared with others without your prior consent.** Use the comments field to provide any additional information you would like to share about your business to HNB. If you have questions, please contact Pamela Hoskins, Program Director (314)977-3625 or Pamela.Hoskins@slu.edu. Thank you for your interest in the Habitat for Neighborhood Business program.

Do you currently own a business?
Do you have a current business plan?
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Do you have a website?
If no, would you like one?
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Is this business an:
Is this business incorporated?
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We have a Business Bank Account:
We have an Accountant
Does business have any active or pending lawsuits?

The Company or Organization's Leadership; Owner, President or Executive Director

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Do you have other employment in addition to your position with this business/organization?
Do you plan to have other employment in addition to your position with this business/organization?
Have you ever declared bankruptcy?
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Referrals to Organizations in St. Louis that provide training for small business owners

For some applicants, HNB will refer them to organizations in St. Louis that provide additional training and services, especially if the business is a new business or one that an applicant is planning to open. For these applicants, HNB will provide to the organization : 1) your contact information (name, title, business address, business phone number and business email address, personal cell phone number and personal email address) and 2) basic information about your business (business name, the description of the business, whether or not you currently own a business, number of years in business, whether or not your company has a business plan, and how your company was formed, ( i.e. LLC, Sole Proprietor, etc.) Please indicate below that, if HNB refers you to a community organization that helps small businesses, you give permission for HNB to release your contact information as noted above and basic information about your business as noted above.

HNB has my permission to release my basic contact information (as noted above) and basic business information (as noted above) to a designated community organization that provides services for small businesses

CERTIFICATION AND RELEASE

I certify that all the information contained in this application is correct and true to the best of my knowledge. Furthermore, I understand that the completion of this application in no way guarantees that I will be selected for the HNB program. Furthermore, I hereby authorize HNB through BetterNOI to order a background check of criminal history and driving record and credit history. I also give my permission for HNB to receive information regarding me for references. I understand that any such information will be used for the sole purpose of evaluating my application for selection into the Habitat for Neighborhood Business program.

Question only for applicants who are planning to start a business:

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