CRM Horizons Bootcamp  - Applicant Intake Form

Please complete the following information.

Applicant Information





Hidden Parameters
This element is used for capturing GA fields so that they can be mapped to Salesforce. 
Map the fields below in the Salesforce (or other) connector. 

NOTE: this entire section is hidden on the form









<code> <code>
Business Information





Example 2004



This would be your 9-digit business number provided by the CRA



North American Industry Classification System
For more BC Registration Number information visit: https://www.orgbook.gov.bc.ca/search
*** For information on your Industry & NAICS Code, please visit the Statistics Canada link below.
https://www23.statcan.gc.ca/imdb/p3VD.pl?Function=getVD&amp;amp;TVD=1181553
Business Address

City and Province NOT required (Example: 838 Fort Street)



No spaces or "-". (Example: V3V1V1


Business Relationship


CRM Stream 1 or Stream 2

Attestation
I,
Full Name
,
Position
at
Name of Business
I confirm that I am the owner or an authorized employee with signing authority for the applying business. Additionally, I verify that the business meets the following eligibility criteria:

  • The business has generated a gross revenue of at least $30,000 in the past 12 months or, for businesses operating for less than one year, since its incorporation/registration.
  • The business employs fewer than 500 people.
Stream 1 Start Date

Technology Information



The cumulative amount of money invested in technology.
Existing CRM Information




What role below BEST describes your involvement with the CRM at your company? *
Program Proposal
Please provide a brief summary about why you believe this program will help benefit your company. *
Equity, Diversity and Inclusion


Please select, if any, the equity seeking groups with whom YOU identify with.

(If you don't identify with any of these groups you may select either the None of the above or I prefer not to answer options at the bottom)



Self-Identification as a member of an Employment Equity designated group is voluntary. The information you provide is confidential and will be used for statistical reporting purposes only. EDI data may include gender, Indigenous (First Nations, Métis or Inuit) identity, immigration recency, disability status, LGBTQ2 identity.


Please select, if any, the equity seeking groups with whom THE BUSINESS identifies with.

(If you don't identify with any of these groups you may select either the None of the above or I prefer not to answer options at the bottom)



Self-Identification as a member of an Employment Equity designated group is voluntary. The information you provide is confidential and will be used for statistical reporting purposes only. EDI data may include gender, Indigenous (First Nations, Métis or Inuit) identity, immigration recency, disability status, LGBTQ2 identity.

Please review and complete the following:


Consent

I consent to the collection and use of the details provided in this application by Alacrity Canada in order to assess and review against the eligibility criteria as noted in the Program Guide. *

At Alacrity Canada, we are constantly evolving, expanding our programs, and reaching out to more and more communities in order to provide entrepreneurs the skills, knowledge, network, and capital, to launch, and grow transformational businesses in Canada.


By opting in to receive our emails, you'll be contacted by our team regarding applications you submit to any of our programs.

You may also enroll to receive periodic emails from us about new grant opportunities, programming, and events.


Please confirm: