Scholarship Form 2024

The GROW Nebraska® Foundation has scholarships and financial aid available for low income members and special circumstances. This application must be completed in full.

A GROW Nebraska representative will get back to you in 10 days or less. If you have any questions, contact [email protected].

Date Completed *

Format: MM/dd/yy

First Name *

Last Name *

Business Name *

Business Website

What is your business start date? *

Address Line 1

Address Line 2

City

Zip/Postal Code

Email Address *

Phone Number *

County *

Age *

Gender *

Male Female Other

Race *

American Indian or Alaska Native Asian Black or African American Native Hawaiian or other Pacific Islander White

Ethnicity *

Hispanic or Latino Not Hispanic or Latino

Do you consider yourself a person with a disability? *

Yes No

Are you a U.S. Citizen? *

Yes No

Veteran Status *

Non-Veteran Veteran Service-Disabled Veteran

Month & Year Business Started *

Format: M/d/yyyy

Are you a current client of the GROW Nebraska Women's Business Center? *

Yes No Not yet, but planning on working with them. I am located in or around Omaha.

Are you a current client of Center For Rural Affairs? *

Yes No

Do you have a website? *

Yes No

Do you have a business plan? *

Yes No

Do you sell product online? *

Yes No

Are you a home based business? *

Yes No

Do you have employees? *

Yes No

Number of full time employees? *

Number of part-time employees? *

For the most recent full business year, what were your Gross Revenues/Sales? $ *

For the most recent full business year, what were your +Profits/-Losses? $ *

What is the legal entity of your business? *

Sole Proprietorship Corporation LLC S-Corporation Partnership Other

In your family household, how many Adults do you have? *

In your family household, how many Children (under 21) do you have? *

What is your family income per year? *

Below $9,999 Between $10,000 & $14,999 Between $15,000 & $19,999 Between $20,000 & $24,999 Between $25,000 & $29,999 Between $30,000 & $39,999 Between $40,000 & $49,999 Above $50,000

Did you file a business tax return last year? *

Yes No

Was your household income: *

Higher than last year Lower than last year About the same

Do you have a website? If so, please paste url. *

Would you like to be added to our email list? Please select 1 or more options. *

Newsletter Inquiry None of the above

How are you currently marketing your business? *

Social Media Amazon, Ebay, Etc. Personal Website Craft Shows Whole Sale Other

Are you looking to apply for Basic or Bundle Membership? *

Basic Membership (help me get more online presence with promotion & Awareness) Bundle Membership (the above + sell my products on your platforms)

Are you planning to list products with us, online and in store? *

Yes No

I understand that this is not a promise of scholarship. *

I agree

This Application is Complete and Accurate. *

By checking this box, I hereby attest that my response and the information provided on this form are true, complete, and accurate.