Kiva Loan Endorsement Application

Florida Kiva Loan Endorsement Application

First Name *

Last Name *

Email *

Phone *

Please select the option that best characterizes your business status *

Start-up

Established

Business Name *

If you have a website for this business, list it:

How is your business legally organized (e.g., sole proprietorship, incorporated, benefit corporation, etc.) *

Do you have a physical location for this business? If yes, provide address. If no, indicate planned property needs. If not applicable, state N/A. Find out about applicable city/county zoning restrictions on your proposed business. *

Briefly describe past attempts, if any, to find additional funds for your business, or simply state "none." Have you sought funding and been unable to obtain it? Not being able to access traditional funding sources (e.g., bank loans, SBA) does not disqualify you in any way. *

Enter total $ amount of funding needed for this proposed project. *

Below, describe the project you will undertake and provide a simple budget outlining expected use of the funds.

EXAMPLE:

SET UP NEW GROW OPERATION
Well - $4300
Greenhouse - $5500
Pots & soil - $2200
Liners - $3000
Total funds needed: $15,000

Describe your project and provide simple budget. *

Describe the expected impact of having the funds and executing your project successfully. How will you measure the impact (e.g., increase in production or sales) ? *

Describe any additional assistance or involvement you would like from foundation representatives during the execution of your project -- this is in addition to foundation assistance with Kiva loan fundraising)? *

none

business mentoring

business training

hands on assistance

other

OTHER: describe other possible foundation involvement you desire in your project

Briefly describe timeframe for project - include desired start date and anticipated completion date, as appropriate *

APPLICANT BUSINESS EXPERIENCE

Please gather additional information as follows and email to executive@nativeplanthort.org

ALL APPLICANTS

Provide a general one-page or less business plan, outlining:

your business and its management
the types of native plants and services provided (or intended)
market you serve
your competition and what sets your business apart from competitors
your marketing and sales strategy.

Provide a one-page or less personal resume describing your work history and/or education.

ESTABLISHED BUSINESSES, please provide e a recent P & L statement and Balance Sheet.

What other resources or partners do you have available to assist with your project? *

PRIOR TO FINAL ENDORSEMENT

Selected applicants are invited to coordinate a scheduled onsite visit by a representative of the foundation's Florida Kiva Program Committee. Final endorsement is contingent upon successful site visit.

Selected applicants are provided a digital agreement to sign that includes the following statements and certifications:

Applicant understands that the foundation acts as an endorsing trustee only, and is not responsible for approving or managing the actual loan or committing funds to the campaign or loan
Applicant is not personally related by family, marriage or conflicting business relationship with any member of the foundation board of directors, staff or the foundation's Florida Kiva Program Committee
Borrower must comply with all Kiva requirements
Borrower shall coordinate a schedule with foundation to report progress via email
Borrower shall facilitate and allow the foundation to publicize funding and collaboration with the project, including the use of photos, video and audio
Borrower shall provide a short final report within 90 days of completion of the project, documenting execution, total impact and next steps or future plans.

QUESTIONS?

Please use our website contact form to ask questions.

I have reviewed and understand this application form. *

YES

NO

How did you hear about this program?

email

social media

website

direct referral

other

Please opt in to at least one form of communication.

FOLLOWING SUBMISSION OF THIS FORM, you will receive an automatic email reply identifying next steps. For established businesses, this includes providing recent financial reports. For all businesses, this includes providing a brief resume and business plan. Please be sure to watch for email from executive@nativeplanthort.org and reply promptly for consideration.

Thank you!