Butte County Business Incubator Program
Building Butte County one business at a time
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Business Incubator Program Application
First Name:
Required
Last Name:
Required
Title:
Business Name:
Address:
Required
City:
Required
State:
Zip:
Business Telephone:
(
)
Ext:
Business Fax:
(
)
Cell Phone:
(
)
Email:
Required
Is your business located in the unincorporated area of Butte County?
Yes
No
Unknown
If you answered Yes, (business located with in the unincorporated area of Butte County), please answer these questions:
Please state your adjusted gross income for the previous year as reported on your federal tax returns. Typically, this information appears on line 34 of your federal tax return.
Year:
$
Required
Please indicate the total number of people in your household:
Required
Type Of Business:
Other
Agriculture
Manufacturing
Technology - Hardware
Technology - Software
Service
Wholesale
Retail
Time In This Business:
0
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
>15
Years
0
1
2
3
4
5
6
7
8
9
10
11
Months
Number of Full-time Employees:
Required
Number of Part-time Employees:
Required
Annual Revenue:
$0
$0 - $20,000
$20,000 - $100,000
$100,000 - $500,000
>$500,000
Brief Description of Business:
Target Markets/Customers:
I certify that all information provided in this application is true and correct.
Enter the code shown below:
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