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First name*

Last name*

Phone*

Gender

Email*

Company name*

State where your business is registered:*

When did you start your business?*

How much revenue do you generate per year?*

If your business is less than a year old what’s your revenue so far?*

Website or Social Media Page*

Describe your story and the nature of your business.*

How would you use the funding?*

Outta Excuses

grant@outtaexcuses.com

9815 Sam Furr Rd Ste J289
Huntersville, NC 28078

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