JOIN THE EQUITABLE ENTREPRENEURIAL ECOSYSTEM (E3)

Please take a moment to complete this intake form. Your responses will provide us with a better understanding of you and your business or organization, enabling us to serve you more effectively. Upon completion, you will receive a formal welcome email with instructions for the next steps. We eagerly anticipate learning more about you and assisting you in achieving your goals.
If you require any assistance, please email [email protected].

Become an E3 Member

Step 1 of 3

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Name(Required)

First Last

Email(Required)

Phone(Required)

Preferred Method of Contact(Required)

Phone

Text Message

Select all that apply.

Business Name(Required)

Website

Business Address(Required)

Street Address Address Line 2 City State ZIP Code

Are you the owner of this business?(Required)

Yes

Business Information

The following questions allow us to understand where you are within your entrepreneurial journey, whether that be the conceptual, emerging, stable or accelerated stage. PDFF supports entrepreneurs and businesses at every stage. Please answer truthfully.

Entrepreneurial Stage(Required)

Conceptual: I have a concept for my business, but it has not been launched yet. I have no noted revenue and I have not completed a business plan or market analysis.

Emerging: I have launched my business but we are in the early stages of start-up, with at least one of the three foundational elements in place (business plan, market analysis, and/or revenue).

Stable: My business is launched, operating, and turning a profit. Scaling is the most pressing need. We have at least two of the three foundational elements in place (business plan, market analysis, and/or revenue).

Accelerated: My business is growing and needs additional support and capital to accelerate further.

Self-identify where you think you are within your entrepreneurial journey. PDFF is equipped to support entrepreneurs and businesses at every stage. This information helps us understand your business so that we can appropriately review your application and provide you with the best resources and support.

Tell us about your business.(Required)

Give a brief, high level description of what your business is about and what products or services you offer.

Do you have a business license?(Required)

Yes

What areas do you serve?(Required)

Delaware (Statewide)

New Castle County

Kent County

Sussex County

Maryland

Pennsylvania

New Jersey

Other

Select all that apply.

What is the structure of your business?(Required)

Select one.

Industry(Required)

Agriculture

General Retail

Education

Science, Bioscience

Construction and Manufacturing (e.g. real estate, energy companies)

eCommerce, Logistics, Transportation (e.g. online retailers such as Amazon, delivery services such as, Fedex, etc.)

Financial Services (e.g. banking, insurance companies, etc.)

Healthcare and Social care (e.g. hospitals, senior homes/assisted living facilities, childcare/daycare facility)

Technology (e.g. data and tech-related companies such as Google, Microsoft, AWS)

Hospitality, Retail & Customer Service (e.g. hotels, food and restaurants, call centers, etc.)

Creative, Entertainment, Art

Other (includes law, marketing, accounting, charities, government, education)

Not available

Select the best answer that applies.

Do you have a current business plan?(Required)

Yes

If you answered yes, when was your plan written?

Have you conducted a market analysis?(Required)

Yes

If you answered yes, when was your plan written?

Revenue & Funding

Our goal is to help you increase your revenue. We ask for this data to help us assess where you are and how we can help you grow. Please answer truthfully.

Previous Year Revenue

Our goal is to help you increase your revenue. We ask for this data to help us assess where you are and how we can help you grow. Please answer truthfully.

Current Year Revenue

Our goal is to help you increase your revenue. We ask for this data to help us assess where you are and how we can help you grow. Please answer truthfully.

Forecasted Revenue

Our goal is to help you increase your revenue. We ask for this data to help us assess where you are and how we can help you grow. Please answer truthfully.

Revenue Explanation(Required)

Enter NA if not applicable

Grant Funding: Have you applied and/or received any grant funding?(Required)

Yes, applied

Yes, received

Grant funding explanation(Required)

Enter NA if not applicable.

Loans: Have you received any loans for business operations?(Required)

Yes

Business Growth Challenges(Required)

Attracting and retaining employees

Attracting clients

Management of remote work

Confidence in business management

Increasing efficiency (operational challenges)

Time Management

Marketing

Difficulty defining value proposition (standing out in the market)

Difficulty understanding ideal client

Supply chain disruption

Lack of business plan

Lack of understanding in financial management and/or problems with cashflow

Pivoting to a new business model

Declining profits and rising operational costs

Limited access to capital

Lack of access to coaching and mentorship

Other

Select all that apply.

Business Growth Challenges: If answered "other"

Expectations: What do you hope to gain from joining E3? Specify the services and type of support you are most interested in receiving.(Required)

Organizational Structure

Briefly introduce yourself and tell us why you started your business. Include your level of experience within your industry.(Required)

Is this business your primary source of income?

Yes

# of full-time employees, not including yourself(Required)

# of part-time employees, not including yourself(Required)

Leadership Structure(Required)

1-2 Founders working full-time

2+ Founders working full-time

1-2 Founders working part-time

2+ Founders working part-time

Other

Board of Directors: Does your business have a board of directors?(Required)

Yes

Financial Support: Does your business have an accountant?(Required)

Yes

Legal Support: Do you have an attorney for your business?(Required)

Yes

Existing Relationships

PDFF partners with many organizations across the entrepreneurial landscape. It is helpful to know who you are already working with so we can make the most appropriate recommendations to best support your growth.

Are you currently working with any organizations, consultants, service providers or participating in other accelerator programs?(Required)

Yes

Describe any existing relationships or partnerships with programs, organizations, consultants, service providers, etc.(Required)

Enter NA if not applicable.

Social, Environmental & Workforce Impact

We define "impact" as a function of both the number of people or communities who will benefit from your business services and the magnitude of the benefit that will yield.

Does your business incorporate social, environmental and/or workforce impact in its business model?(Required)

Yes

If you answered "Yes" briefly explain how it is incorporated into your model.

Level of Impact(Required)

Select the best answer that applies.

Workforce Growth: How many new employment opportunities will your business create within the next three years?

1-9

10-19

20-49

50-99

100+

Demographic Information

E3 was created to be welcoming and inclusive. The first step to inclusivity is data collection. Some of the questions asked within this section are required for data collection purposes and will not affect your eligibility to move forward.

Ethnicity

Asian

Black, African American, Black British, Caribbean

Hispanic/Latino

Indigenous or Native Peoples

Multiple racial/ethnic groups

North African/Middle Eastern descent

White

Another race and/or ethnicity

Not Available / Prefer not to disclose

Gender

Age

Is your total household income under $58k per year?

Yes

We ask this question specifically on behalf of our funding partners to report on the percentage of individuals who classify as low to moderate income (LMI) persons. Your answer will be kept confidential.

Is this a minority owned business?

Black

LGBTQ+

Veteran

Disability

Hispanic

Asian

Logo Upload

Max. file size: 2 MB.

Please upload a jpg or png high-quality logo.

How did you hear about us?

From a friend or colleague

Web Search

PDFF Website

Other Website

Facebook

Twitter

Instagram

Other

Newsletter & Emails

I understand.

By submitting this form, we will automatically subscribe you to our e-newsletter and other program related email notifications that include information regarding upcoming events and announcements. You can unsubscribe at any time.

Consent

I agree.

I recognize that the Pete du Pont Freedom Foundation is a 501(c)(3) nonprofit organization, and I am fully aware of the organization's mission, vision, and values. I understand that I do not speak for the Pete du Pont Freedom Foundation or any of its initiatives, including E3, and I will act in good faith regarding the promotion of the Pete du Pont Freedom Foundation and its initiatives.

I am aware that the information obtained in this application may be shared with affiliates of the Pete du Pont Freedom Foundation, including but not limited to board members, staff, E3 committee members, and E3 partners.

As a member, I agree to share data about my business or organization as requested by PDFF and complete 30-day, 90-day, and annual surveys in a timely fashion. I understand that this data is essential for the sustainability of E3.

I acknowledge that photography and/or video footage may be obtained during Pete du Pont Freedom Foundation meetings and events for promotion and marketing purposes, and I give permission for my image to be used. Additionally, I agree to allow my name and business to be included in, but not limited to, the Pete du Pont Freedom Foundation website, social media, and news releases.

Membership Level(Required)

Premium - $1,200

Emerging - $600

Entry- $300

Total

Credit Card

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