Empower Application

Empower Application
Address *
I am ok with empower sending me text message in order to communicate with me about the program and program partnerships. *
Please select the group you most identify with.
Please select the ethnic group you most identify with.
Are you fluent in reading, writing and speaking English?
Do you speak another language?
Highest level of education completed (please select one *
Have you ever taken classes or training in any of these areas?
Are you employed? *
If 'Yes,' are you employed:
Are you able to commit to Monday/Wednesday or Tuesday/Thursday evenings from 6-8 p.m. for 6-8 weeks to participate in Empower? *
Have you participated in or completed the PATHS program?
Will you need support or assistance with transportation in order to participate in Empower *
Will you need childcare support or assistance to participate in Empower *
Which best describes your stage of business development? *
If you are in business, how long have you been in operation?
Have you sold any products or services? *
Have you or any of your partners ever started a business before? *
Have you ever worked in a business similar to the one you currently own or would like to own? *
Operating your own business may require working more than 12 hours a day, 6-7 days a week, and possibly holidays. Are you prepared to invest this much time to your business? *
Establishing your own business may require that you temporarily lower your standard of living. Are you prepared to adjust your lifestyle accordingly? *
The following list contains just a few of some of the potential benefits associated with Empower. Please select the top three benefits to you regarding your business’ development and success. *
How did you learn about Empower? Check all that apply.
I understand that if accepted into the Empower program I will be responsible for paying a $75 program fee prior to the first day of class. The fee is nonrefundable as it is used to ensure that I have the best experience possible. *