GE Capital: Banking on Women Form

Banking on Women™ Training Program

* Given your understanding of the Banking on Women™ program, why do you think you would make a good participant? What is your primary motivation for applying? Please explain any experience or background that you think makes you a strong candidate for the Banking on Women™ program. (Note: 1000 character limit)

How did you hear about Banking on Women™? (Note: 300 character limit)

The Banking on Women™ Training program will be a 12-week course that meets one evening per week for 3 hours at a location in South Salt Lake. If I am selected to participate in the Program, I understand that I will be required to attend at least 10 of the 12 scheduled sessions and complete all related homework to successfully finish the program.

By checking this box, I hereby acknowledge that I have read this entire application as completed, and that each response is true and complete to the best of my knowledge and accurately reflects my intended response.

About Your Business

Please answer all questions to the best of your abilities, keeping in mind that you may not yet have the full answer to each question. All of the information you provide will remain confidential.

Are currently in business?:

Yes No

How long have you had it?:

Months: Years:

Website:

How many new jobs will you create?:

How many existing jobs will you retain?:

* Brief Description of your business idea:

* Why do you want to be self-employed?:

Business Operations

* Do you have a location for your business?:

Yes No

* please describe the location and why you chose it:

* Will you be employing other people?:

Yes No

* please describe what they will be doing for you:

* Do you have a person or resource to turn to for advice and support?:

Yes No

* please describe:

* Anticipated timeline for starting your business (if just starting your business):

* Please list any goals you hope to reach in the next 12 months:

Marketing

* Description of the products and/or services you intend to sell:

* Have you determined how you will price your goods/services?:

Yes No

* please describe:

* Who do you see as your market (businesses or people who you will sell to)?:

* How do you intend on communicating/advertising to potential customers?:

* Who are your competitors?:

* Why would your customers buy from you vs. the competition (what is your âmpetitive advantageâ

* Have you performed any market research?:

Yes No

* please describe:

Finances

* Will you be putting any of your own money into this venture?:

* Will your business provide primary âor supplemental âincome?:

Primary supplemental

* Would you consider borrowing money to get your business started?:

* If you were to request a loan, what would you be able to offer to secure the loan (collateral)?:

* How is your credit history?

excellent good fair poor

* If you donâknow, go to ânualreport.comâ

* Credit score:

* From:
Experian TransUnion Equifax

Personal demographic information (OPTIONAL)

The following information helps us determine the impact of the program in the community.

Age:

Last Grade Completed:

Are you the primary wage earner in your household?: Yes No

What is your total personal (as opposed to household) annual income?

What is the primary source of your household income?

Personal Cash Flow

Monthly Household Income (after-taxes from all sources)

Only list income that will remain in place once the business has been started.

* Source (please specify):

* $:

Source (please specify):

$:

* Total Monthly Household Income $:

Monthly Household Expenses

* Rent/Mortgage:

* Utilities:

* Insurance (home and auto):

* Auto Loan Payments:

* Credit Card Payments:

* Student Loan Payments:

* Other Bank Loan Payments:

* Food/Groceries:

Other (please specify):

* Total Monthly Household Expenses $:

* Net Monthly Personal Cash Flow (Income minus Expenses) :

Personal Balance Sheet: Assets

Please estimate the value of what you own.

* Cash in Banks (please list):

* $:

* Real Estate (primary residence):

* Automobiles (please list):

* $:

* Retirement Accounts:

Other Assets (please list):

$:

* Total Assets:

Personal Balance Sheet: Liabilities

Please estimate the total amount that you owe.

* Total Mortgage Balance:

* Total Auto Loan Balance:

* Total Credit Card Balance:

* Total Student Loan Balance:

Other Liabilities (please specify):

$:

Other Liabilities (please specify):

$:

* Total Liabilities:

* Net Worth (Assets minus Liabilities):

* Required fields
Submit

Banking on Women™

Application

About You

Banking on Women™ Training Program

About Your Business

Business Operations

Marketing

Finances

Personal demographic information (OPTIONAL)

Personal Cash Flow

Monthly Household Expenses

Personal Balance Sheet: Assets

Personal Balance Sheet: Liabilities