Toll-Free: 1 (877) 228-7810 Introducing Northern New York Artisans and Producers to the World.

Apply for the NATC Program

If you prefer to download the application as a PDF, complete it and return it to us by fax or mail, please click here to download the PDF Application .

General Contact and Business Information

Fields marked with an asterisk (*) are required to submit this form successfully.

Contact Information

Full Name:*

Mailing Address: *

City * State: * Zip Code: *

Phone: *

Business Contact Information

Business Name:

Business Mailing Address:

City State: Zip Code:

Business Phone:

Business Fax:

Business Email:

Business Web Address:

Is Your Business a Partnership?

No Yes

Where are you right now in the business process?

Check all that apply. Select at least one.

I am still trying to decide whether to start my own business.
I am in the process of starting my own business.
I have been selling my product or service for less than 12 months.
I have been selling my product or service for 12 months or more.
I have been selling my product or service for 12 months or more and I am documenting a net profit.

What is your business or business idea?

Arts/Crafts
Business Services
Clothing Accessories/Textiles/Home Furnishings
Food
Personal Service/Beauty
Other

Business Description Short Description

What type of items do you produce for sale?

How much merchandise do you currently sell each week, and how do you sell it?

Business Classification

Check all that apply. Select at least one.

This is a women-owned business.
This business is an in Empire Zone.
I am disabled.
This is a minority-owned business.
This is a veteran-owned business.
This is a home-based business.
I am engaged in import/export trade.
This is a part-time business.
My business is seasonal.

American Indian or Alaskan Native
Asian
African American
Hispanic/Latino
Native Hawaiian/Pacific Islander
White
Other

Employment Status

Check all that apply. Select at least one.

Self Employed
Employed by someone else
Full-time Homemaker
Unemployed
Hours Devoted to Your Business Weekly:

Business License and Status

Do you have any of the following?

Check all that apply. Select at least one.

Business License
Seller's Permit/Sales Tax #
Registered DBA
Patent
Trademark
Copyright
Business Plan

Income

What percent of your income would you like to come from your business earnings?

Business Form

Sole Proprietorship
Partnership
Corporation
S-Corporation
Limited Liability Company

Employees

Yes
No

Sales What were your total sales and expenses in the past year? If you do not keep records, please estimate to the best or your knowledge.

Client Information

Has anyone in your family ever owned a business?

Yes
No

Veteran Status

Veteran
Non-Veteran
Service-Connected
Disabled Veteran

Marital Status

Married SP (spouse present)
Married SNP (spouse not present)
Divorced
Never Married
Unmarried living with partner
Widowed

Education

Less than HS
HS/GED
Some College
College AA/AS
College BA/S
Graduate Degree
Vocational
Other

Your Computer, Internet and Digital Technology Experience

How would you describe your computer and internet experience?

I've never used a computer
I have basic knowledge of computers and the internet
I have significant experience using computers and the internet

Search Engines Name three major search engines.

Do you understand how search engines work?

Yes
No

Have you ever used a digital camera?

Yes
No

Questions about Your Knowledge of eBay

Have you ever used eBay?

No
Yes. As a Seller
Yes. As a Buyer

Availability

When are you available for program sessions?

Check all that apply. Select at least one.

Weekday Mornings
Weekday Afternoons
Weekday Evenings
Weekend Mornings
Weekend Afternoons
Weekend Evenings

Questions Pertaining to the Project

Program Attendance

Are you willing to attend business development program one night each week, a two-day-long training session and various business networking sessions over a time-period of six months?
Yes
No

Do you have a marketing plan completed?

Yes
No

Financing How do you finance your business activities?

Do you require a micro loan to assist you with business expansion, increased inventory or capital expenditures?

Yes
No

Your Goals How do you see the internet helping you to grow your business?

What do you hope to accomplish as a business participant in the Northern Adirondack Trading Cooperative?

Agreement and Signature

From time to time, NATC collects follow-up information from its clients to learn more about the economic, business and employment experiences clients have experienced. I agree, as an active client, to provide certain information to NATC on a timely basis. If I am asked to provide confidential data, I am assured that my name will not be attached to the data and I can be confident that the information will be shared in a trustworthy manner.

The Northern Adirondack Trading Cooperative, a program operated in partnership with Rural Opportunities, Inc. and the St. Lawrence County Chamber of Commerce and is an Equal Opportunity Lender, Provider, and Employer.

Full Name:

Your Signature:

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