ICA Portfolio Company Application |

The ICA Portfolio is made up of growing inner city businesses that are dedicated to creating quality inner city jobs, and building socially responsible businesses. The ICA portfolio represents many industries from artisan food manufacturing, to commercial services and custom product manufacturing. Please complete and submit this form and we'll get back to you soon!

Company Name*
Primary Contact*
FirstLast
Title*
Address*
Street AddressAddress Line 2CityStateZip Code
Website
Email*
Primary Phone*
Mobile Phone
Fax
Company Description*
Business Type*
Tax ID Number*
Key Management
Please list the key management, their titles, and primary responsibilities.

Employment and Financials
For each of the questions in this section, please enter the values for each corresponding Fiscal Year.
FYE THREE years ago:
Full Time Employees:
Part Time Employees:
Revenue:
Gross Profit:
FYE TWO years ago:
Full Time Employees:
Part Time Employees:
Revenue:
Gross Profit:
Last FYE:
Full Time Employees:
Part Time Employees:
Revenue:
Gross Profit:
Expected THIS year
Full Time Employees:
Part Time Employees:
Estimated Revenue:
Estimated Profit:
Expected for next FYE:
Full Time Employees:
Part Time Employees:
Estimated Revenue:
Estimated Profit:
Expected for FYE in TWO years
Full Time Employees:
Part Time Employees:
Estimated Revenue:
Estimated Profit:

Please briefly describe your growth strategy:*
Vacation days offered:
Sick leave (days):
Employment stock ownership plan:
Yes
No
Career Ladder / Path:
Please describe the career growth opportunities for your staff.
Community Commitment:*
Please explain your company's commitment to the greater community through its product/services and/or business practices.
Environmental Commitment:*
Please explain your company's commitment to the environment through its products/services and/or business practices.
Local Supply Chain:*
We encourage companies to be as local as possible and we realize that your business makes in impact in the community when you use other local businesses who supply goods and services to you. Please list any local companies that your business uses.
Why should your business be selected for the ICA Portfolio?*
How will your company benefit from ICA's services?*
Do you have the time for ICA advising?*
Yes
No
Additional Comments:
How did you hear about ICA?:*
Please enter here:*

Please include a BUSINESS PLAN, your most recent FINANCIAL STATEMENTS (including Balance Sheet and Income Statements for last three years, YTD, and 2-3 year financial projections, if available) and any SUPPORTING MATERIALS (marketing collateral, press coverage, etc.). Please attach them below.
Additional Documents:
If possible, please create a ZIP file of all the above documents.
More Documents:
Please use this and the next two fields ONLY if you have NOT used a ZIP file in the previous field.
And More Documents:
And Even More Documents:

Become a Portfolio Company

ICA Portfolio Company Application

Step 1 of 5

Employment and Financials