Ascend Long Island Full Application

Business Name:

Owner's Name(s):

Address Line 1

City

State

Country

Phone:

Cell:

Fax:

Email:

Website:

LinkedIn Profile:

What industry sector does your business identify with?

Is the business at least 51% owned and controlled by individuals belonging to certain ethnic minority groups such as African-American, Asian, Hispanic or Native American descent?

Yes

Please list your SIC/NAICS Code(s):

Number of employees (including owners):

Number of locations (if more than 1 location, please list):

Years in Business:

Tell us about your business, including what problem(s) does it solve for your customers?

What are your company’s Mission and/or Vision Statement?

Describe your target market:

Describe in detail your short-term goals [next 12 months} for growing your business.

Describe in detail your long-term goals [3-5 years] for growing your business.

How much capital does your business require to achieve your growth goals?

Describe your team (titles/responsibilities):

What are the critical needs of your business that you would like to address by participating in the Ascend Long Island program?

What are you most interested in learning about that you feel would be necessary to scale your business?

What is your yearly marketing budget?

Who are your significant competitors?

What benefits do you offer that are unique and beyond what your major competitors offer?

Are you affiliated with any business networks or organizations that assist entrepreneurs? If yes, which?

Yes

Affiliated with:

Who manages your finances?

Internally Managed

CPA

Compiled

Other

Do you use an electronic accounting system?

Yes

Do you make and follow an annual budget?

Yes

What was your annual gross revenue over the past 3 years? 2025 - 2024 - 2023:

What was your net-tax profit over the past 3 years? 2025 - 2024 - 2023:

Do you have a plan for financing future growth in your organization?

Yes

How much do you need to implement long-term goals?

Are there specific licensing requirements for your industry/trade?

Yes

Please list all licenses that you hold:

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