Stakeholder Applications Closed

Thank you for your interest in becoming an RICE Stakeholder. We are not accepting applications at this time.

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Step 1 of 4

A background check, orientation, and participation in a short prospective stakeholder interview are required with the application process.

Welcome

Submit one business per application. Multiple submissions will be subject to multiple Stakeholder Plans.

Welcome to the Russell Innovation Center’s Stakeholder application!

We’re delighted that you’re applying to become a stakeholder. We are eager to learn more about you as you learn more about us. In the meantime, this application will help us get a sense of who you are as an entrepreneur. Whether you’re a startup or an existing business owner, we encourage you to complete it as thoroughly as possible. We know we’ll be impressed with the incredible skills and values you demonstrate.

Warmest wishes,
RICE Family

RICE Stakeholder Agreement

As part of our application process, we will ask that you complete a background check and participate in a short prospective stakeholder interview so that we can get to know you and your business better. Please note that If you are selected to be a stakeholder you will need to attend an orientation at RICE

1. What are your expectations from RICE?*

2. How did you hear about RICE?*

3. What are (3-5) goals for your business*

4. What challenges are you experiencing in achieving these goals?*

5. Stakeholder Plans*

Base $100

Base + Mail $125

Base + Dedicated Desk + Mail $225

Base + Dedicated Desk $200

Team Plans: Base + $50 for each additional team member (up to two team members). List team members names and email addresses added to the plan.

Team Member 1 – Full Name*

Team Member 1 – Email*

Team Member 2 – Full Name*

Team Member 2 – Email*

Personal Information

6. Name*

First Middle Last Suffix

7. Email*

Enter Email Confirm Email

8. Phone Number*

9. Alternate Phone Number (optional)

10. Address*

Street Address Address Line 2 City State ZIP Code

11. County*

12. Date of Birth*

13. Race/Ethnicity*

14. Gender*

15. Marital Status*

Emergency Contact

16. Full Name*

First Last

17. Phone*

18. Relationship to entrepreneur*

Education Background

19. Highest level completed*

20. Did you attend an HBCU?

Yes

No

22. Veteran Status*

Business Administration

23. Name of Business*

24. Your Title*

25. Business Address*

Street Address Address Line 2 City State ZIP Code

26. Business Email Address*

27. Business Phone Number

(000) 000-0000

28. Business Website

Please enter a valid Website URL

29. How many years have you been in business?*

30. EIN#*

If you don’t have an EIN#, then enter N/A.

31. What is your legal business structure?*

In which state(s)?*

Provide proof of incorporation*

Accepted file types: jpg, png, pdf, jpeg, Max. file size: 5 MB.

Please upload your proof of incorporation document. You can provide a JPG, JPEG, or PNG file. It must be no larger than 5 MB.

32. Written business plan*

Yes

No

If yes please provide a summary in three to five sentences.*

33. Ownership Percentage*

34. Business Investors (% ownership)*

35. Business Investor names*

36. Co-Owners (% ownership)*

37. Co-Owner Name(s)*

38. Social media handle*

Facebook

Instagram

Twitter

Other (specify)

none

Other*

Business Operations

39. Business Type – What is your customer base?*

40. Industry categories: Select one*

Other (Please specify the type of business)*

41. Please tell us about your business and/or product branding. Provide a description of your business brand. If you do not have a business but you have an idea or concept, please describe it.*

42. Business Legal Structure*

43. Select Type of Corporation*

44. Does it qualify as a small business corporation (SBC)?*

45. List any business-related licenses.

Stakeholder Applications Closed

Welcome

RICE Stakeholder Agreement

Personal Information

Emergency Contact

Education Background

Business Administration

Business Operations

Human Resources

Business Marketing

Business Finances

Who We Are

Events

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