StartUP FIU | Incubator Application Form

StartUP FIU Food Incubator | We accept applications annually between November 1st - March 15th.

Please state “N/A” regarding any questions you are unable to answer.
Main Contact Name: Main Contact Name: First Last
Business Name:
Business Mailing Address: Business Mailing Address:
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Home Mailing Address: Home Mailing Address:
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Cellular Phone: Cellular Phone: - ### - ### ####
Work Phone: Work Phone: - ### - ### ####
Email:
Website:
Year business was founded:
Year you acquired ownership:
What percentage of the business do you own?
Employee Count: Full Time
Employee Count: Part Time
Annual Gross Revenues for 2018-2019
How did you hear about StartUP FIU- FOOD?

How did you hear about StartUP FIU- FOOD? Program Alumni Business Support FIU Employee Community Development Organization Services (Business Associations, Chamber of Commerce, Small Business Development Center) Media Website Other (Please specify below) Other (Please specify below)
Briefly describe your product.
Please Upload Business Plan (5MB limit):

Attach Files

If greater than 5MB, please email your business plan to Foodfiu@fiu.edu with your company name as the subject.
Describe your target market (provide examples of former or current customers):
List all members of your team (include name, title, and role):
Have you ever worked in a community kitchen or a shared-use space before?

Have you ever worked in a community kitchen or a shared-use space before? Yes No
Are you willing to work with other businesses in the same commercial kitchen space?

Are you willing to work with other businesses in the same commercial kitchen space? Yes No
Would you be willing to answer questions about StartUP FIU Food regarding your experience?

Would you be willing to answer questions about StartUP FIU Food regarding your experience? Yes No
Who will be cooking? (please include employee name and title)
Does this person have professional food experience?

Does this person have professional food experience? Yes No
Please describe:
Does this person have culinary training?

Does this person have culinary training? Yes No
Please describe:
Are you comfortable using commercial kitchen equipment, and have a current "Food Safety Manager Certification?

Are you comfortable using commercial kitchen equipment, and have a current "Food Safety Manager Certification? Yes No
Are you familiar with cleaning and maintaining commercial kitchen equipment?

Are you familiar with cleaning and maintaining commercial kitchen equipment? Yes No
Will you need training for any specific equipment within the kitchen?

Will you need training for any specific equipment within the kitchen? Yes No
Please describe:
What are your anticipated monthly kitchen use hours?
Are you flexible in your hours?

Are you flexible in your hours? Yes No
How many employees will be using the kitchen?
What are your storage needs? Do you have any additional off-site storage?
Do you have shipping/ transportation needs? How will you fill them?
Personal Information

The following questions are optional. Your answer will help track the demographics of applicants and participants.
The information is voluntary and will not be used when considering you for employment with our company.
Racial or Ethnic Group:

Racial or Ethnic Group: American Indian/ Alaskan Asian/ Pacific Islander Black/ African American Hispanic/ Latino White/ Caucasian Other
Gender:

Gender: Male Female
Were you born in the United States?

Were you born in the United States? Yes No
If born outside of the U.S., please indicate country of origin:
I understand that this application does not imply acceptance into the StartUP FIU Food's Incubator program. I also verify that the information provided is complete and accurate to the best of my knowledge.
Emergency Contact Information
Emergency Contact #1: Emergency Contact #1: First Last
Relationship:
Phone Phone - ### - ### ####
Email:
Emergency Contact #2: Emergency Contact #2: First Last
Relationship:
Phone: Phone: - ### - ### ####
Email:
I confirm that the above information is accurate. I understand the confidentiality policy and hereby give permission to StartUP FIU- Food staff to use my information for program evaluation and reporting purposes.
Draw your signature into the box below.

Draw or Type

I understand this is a legal representation of my signature. Clear

Full Name

I understand this is a legal representation of my signature.

StartUP FIU | Incubator Application Form

StartUP FIU | Incubator Application Form

Please state “N/A” regarding any questions you are unable to answer.

Personal Information

I understand that this application does not imply acceptance into the StartUP FIU Food's Incubator program. I also verify that the information provided is complete and accurate to the best of my knowledge.

Emergency Contact Information

I confirm that the above information is accurate. I understand the confidentiality policy and hereby give permission to StartUP FIU- Food staff to use my information for program evaluation and reporting purposes.