Jumpstart/Assessment Questionnaire

Genesis Block Jumpstart is our foundational program designed to support early stage small businesses and entrepreneurs. It consists of two components: Jumpstart Impact Program and the Genesis Block Jumpstart Academy. The goal of the program is to provide founders with the resources they need to validate their business idea.
* Jumpstart Impact Program*
The Genesis Block Jumpstart Impact program provides one on one assistance for anyone that is interested in starting a business. The program includes a monthly consultation, business training webinars and workshops and 2 day monthly admittance to Genesis Block.
Genesis Block Jumpstart Academy*
The Genesis Block Jumpstart Academy is tailored for early stage business owners that are ready to validate their business idea. The academy is an intensive 8 week structured program that provides business owners with the skills, resources and mentoring to support the validation of their business idea.

***PLEASE COMPLETE THE FOLLOWING QUESTIONNAIRE TO ASSIST US IN UNDERSTANDING WHAT PROGRAM BEST SUITS YOUR BUSINESS NEEDS***
Email*
Name*
First Last
Company*
Phone*
Overview of your business?*
Who is your customer base?*
What problem are you solving for your customer?*
What is your solution to the problem for your customer?*
How are you different from the existing alternatives currently servicing your customers?*
Where do you see your business as it pertains to revenue and employee growth in the next 18 months?*