Fields marked with a * are required.

Is your business registered in Nova Scotia? Yes No

Do you consider your business to be a rural business? Yes No

The program requires active participation over the next 6 months. Are you willing to appoint a champion from your business to participate over the course of the program? Yes No *

Does your business have high speed access to the Internet? Yes No *

Have you recently explored growth into new markets? Yes No *

Are you using the web to grow your business? Yes No *

Do you use email regularly for your business? Yes No *

Does your business have a website? Yes No *

Do you have an existing business plan? Yes No *

Does your business have up-to-date financial statements? Yes No *

Is your business in good standing with the Canada Revenue Agency? Yes No *

How long has your business been in existence?

How many people does your business employ?

Business Name *

Primary location of the business (if more than one location please indicate the head office location) *

Contact Name *

Contact Email *

Business Phone *

I agree to the following: *

• I understand that approval into the program is conditional until after a discussion with an ACSBE small business counsellor to discuss the program in more detail and our company’s readiness for the program.
• I understand that at the first meeting with an ACSBE business counsellor I may be required to share my business plan and up-to-date financial statements.
• I understand that if my business is accepted into the program I will have to pay a $200 program fee.
• I understand that this is an educational program and participation in the program does not guarantee business growth or sales in new markets.
• I understand that the information provided here will ONLY be used by ACSBE staff and CBDC Shelburne to determine the readiness of my company for the Get Connected program. My information will NOT be shared beyond ACSBE or CBDC Shelburne or used for any other purpose than that stated above.
• I understand that a representative from my company must attend the two-day workshop on November 14th and 15th at the offices of CBDC Shelburne.

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Thank-you for your interest in Get Connected. A representative will be contacting you regarding your application.