Thank you for your interest in participating in the ECJC's Growth Mentoring Service. After filling out this application, a GMS representative will be in touch to confirm receipt of your application and share next steps.
Business Name:

Business Mailing Address

Point of Contact


First and Last
Telephone number:

Role in the business:

CEO, CMO, Founder, etc.
Past entrepreneurial involvement

Please select all that apply, past and present.

Please list all key or executive team members, their role in the company and how long they've been with the company:

How did you hear about the ECJC Growth Mentoring Service?

If you can't remember, please enter N/A.
About your business

Is your business a legal entity?

Do you have paying customers?

How many paying customers do you currently have?

Did your business generate annual revenues in excess of $100,000 during the last fiscal year?

Does your performance thus far during the current fiscal year (on a monthly average) indicate that you may expect to generate annual revenues in excess of $100,000 in the current fiscal year?

Please do not include growth projections. For instance, if your monthly revenue in each month of the current fiscal year has been greater than $8,333, please answer yes. If not, please answer no.
Is this the first time you've started or worked in a high-growth business?

If no, please describe your past experiences  with high growth business.
About the business opportunity

What do you do?

What problem are you solving?

Who has that problem?

How will you solve that problem?

How do you make money?

What is your "secret sauce" and have you protected (or do you plan to protect) any intellectual property?

What issues are you struggling with right now?

What kinds of mentors do you think you need?

Do you have any additional comments?

Thank you for your interest in the ECJC Growth Mentoring Service program. A representative will confirm receipt of your application shortly.
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