Application for Membership Aplicar en Español!

Please fill out this application completely. StartZone staff will notify you of your application status within one week of the application date. All information provided on this application is strictly confidential. You may also apply by phone by calling 206 592-3388 or in person at 23835 Pacific Highway South, Kent, WA 98032. Map & directions


* Indicates a required field.
Contact Information


 




 
 

Enter at least one phone number

 
 


Best way to contact
        Best time to contact


Demographic Information

Birthdate

Ethnicity (choose one) *









 









       Education


       Gender *

Do you consider yourself a person with a disability? If YES, please describe any accommodations you need in order to participate in StartZone. *
   

   

Are you currently enrolled as a student at Highline College?
   

Are you a first-generation immigrant? If YES, provide information about your native country and language.
   

   
     

What was your total household income last year (please estimate)? * $

Total number of people living in your household (including children)? *

Head of Household?*
   


Business Information

What experiences (in the U.S. or in your native country) do you have that will help you start or grow your business?

Are you currently in business?






  

How does your business make money?

Do you conduct business online?

How many people do you employ? Full-time:    Part-time:

What were your sales for the most recent year? $ 

What were your profits/losses for the most recent year? $ 

If you currently own any other business or have any other sources of income, please describe:


Business Goals

What business goals do you hope to accomplish at StartZone?
Start my new business
Hire employees
Obtain a loan to start or grow my business
Increase sales to $

Other business goals


Referral Source How did you hear about StartZone?
















Other referral source:

 


 

Highline logo - link to Highline home page

2400 S. 240th St
Des Moines, WA 98198
(206) 878-3710
TTY/TDD  (206) 870-4853

Page last updated: February 23 2017

Back to Top :: Home Page :: Staff Login

This web site was developed by and is maintained by StartZone.  If you have questions or concerns about the content, please contact us.

Highline College Web Coordinator: webmaster@highline.edu

Privacy Policy | Public Disclosure