CLIENT INFO:
Full Name
Email
*
Phone
*
Address
Street Address
City
State
Country
Country
Postal code
Program Type Selection
T1 Licensee Cohort - Must have a NYS license
Bootcamp - doesn't need a business, can be in ideation phase
T1 Licensee: "For Those who already hold or are actively pursuing a NYS cannabis license" Bootcamp: "For those in ideation phase - no existing business required"
TYPE OF APPLICANT:
Are you a SEE Applicant? (Select all that apply):
Minority-Owned Business
Women-Owned Business
Distressed Farmer
Veteran-Owned Business
Community Disproportionately Impacted (CDI Resident)
Other
Other (Please specify):
Why are you applying to the B.L.O.O.M. ROC Incubator Program?
DELIVERABLES & TIMELINE:
Do you need technical assistance completing your NYS adult-use market application?
Yes
No
Unsure
I agree to
terms & conditions
provided by the company. By providing my phone number, I agree to receive text messages from the business.
SUBMIT FORM - THANK YOU!
