Full Name *

Phone *

Email *

Address

Street Address *

City *

State *

Country *

Postal Code *

LinkedIn Profile

Instagram / Social Media Handle

YOUR BUSINESS

Business Name *

Business Website *

What industry is your business in? *

How long have you been in business? *

How many people currently work in your business? *

YOUR STORY

Tell us about your business (What do you do, who do you serve, and why did you start) *

Why does your business matter to you? *

What is the biggest challenge holding your business back right now? *

What would you accomplish if that challenge were solved? *

YOUR VISION

Where do you want your business to be three years from now? *

What does success look like for you personally? *

What impact do you want your business to have? *

What kind of legacy do you want to leave? *

This question is particularly important because it connects the application to your Legacy 100 mission.

HOW THE $20,000 WOULD HELP

If selected, how would you use the $20,000 sponsorship? *

Please be specific. Tell us how the sponsorship would help you grow your business, reach more customers, improve your systems, create jobs, increase your impact or achieve an important business milestone.

What would change in your business within 12 months if you received this sponsorship? *

What is the single most important result you want to achieve? *

READINESS

Why is NOW the right time for your business? *

How coachable are you? *

Are you willing to implement the strategies and recommendations provided as part of the sponsorship? *

Are you willing to participate in reasonable progress updates related to the sponsorship? *

Are you willing to share your entrepreneurial journey and results as part of the Legacy 100 story, subject to mutually agreed terms? *

YOUR 60-SECOND STORY

Please share a video link (YouTube, Vimeo, Google Drive, or Loom) answering: Who are you? What do you do? Why does your business matter? Why should you be selected? Video must be 60 seconds or less. Example: https://youtu.be/xxxxx *

This is important.

If you were standing in front of us one year from now, after receiving this sponsorship, what would you want to be able to say? *

FINAL DECLARATION

I certify that the information provided in this application is accurate and complete.

Declaration

I understand that the $20,000 sponsorship is subject to the program's eligibility, selection and sponsorship terms.

Declaration 2

I understand that submitting an application does not guarantee selection.