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ICCC Program Application

Please complete this application form to be considered for this program. You will have a response to your application shortly.

All fields are required unless otherwise indicated.

Company Information
  1. CEO
  2. Company
  3. Number Of Employees
  4. Second Contact (optional)
Program Interest
  1. What part of the program are you most interested in? (check all that apply)
Management Team
Manager 1
Manager 2 (optional)
Manager 3 (optional)
Financial Information
  1. Revenue and EBITDA
    2016 (Actual)
    2017 (Actual)
    2018 (Projected)
    2019 (Projected)
  2. Applicants are encouraged to submit financial statements.**

Finance Sought
  1. (If yes, please complete below.)

  2. What type of financing are you seeking? (check all that apply)

**Inner City Capital Connections Statement of Confidentiality: This application asks for confidential information. Contact information will not be used for other subscriptions, outreach, or marketing without explicit written permission. Application information will not be made available to third parties, except in the form of publications and presentations that do not identify the companies or funds by name, and in which findings and results are presented only on an aggregated basis. Financial information and business plans will be protected and access to them will be strictly limited.