Thank you for your interest in the Global Ignition program. Please complete the application below to be considered for the program. Once you submit the application, our team will review it and contact you to discuss your participation.

Questions? Please contact Steven Murray at steven.murray@trade.gov or 412-644-2819.

Fields marked with * are required.
OMB Control No.: 0625-0237
Expiration Date: 1/1/20
Organization Information
Organization Name:*
Organization Web Site:*
First Name:*
Last Name*
Company Position:*
Email:*
Primary Phone Number:*
Organization Address 1*
Organization Address 2:
Organization City:*
Organization State*:
Organization Zip Code*:
Please indicate your racial identity / ethnicity*
Please indicate your gender identity:*
Do you consider yourself a person with a disability?*
Please indicate any military status:*
What percentage of your business is woman-owned?*
What percentage of your business is male-owned?*
Please provide the month and year your business started:*
Are you 8(a) certified?* Yes  No
Please specify the industry of your business:*
Please specify the legal entity of your business:*
Are you a home-based business?* Yes  No
Do you conduct business online?* Yes  No
Are you currently selling your product or service in the U.S.?* Yes  No
If Yes, for how long?
What industries does your business sell to?
Are you currently exporting your product or service?* Yes  No
If yes, to what countries?
Are you committed to executing your developed strategic export plan within 6 months of completing this 5 month course?* Yes  No
Is your company's President / CEO capable of attending every session?* Yes  No
How many Full Time employees do you have*
How many Part Time employees do you have?*
   
For the most recent fiscal year, what were your:  (this information is kept strictly confidential, please see Use of Information below
Profit/Loses:*
Gross Revenue/Sales:*
Percent of revenue/sales from exporting:*
     
 
What is your primary reason for seeking assistance in growing your company’s exports?*
Why is the timing right for your company to be involved with this program?*
     
Please read the following agreement and select Yes or No below: If accepted for this program I understand my company information and program-developed content for or from my company will be shared with the U.S. Commercial Service, Chatham Women's Business Center Women's Institute, the U.S. SBA, and Western PA District Export Council.
Agree* Yes  No
 
Use of Information: The information in this form is to be provided by individuals and businesses seeking technical assistance services from the Small Business Administration or an SBA Resource Partner. The information is collected to help SBA's continuing improvement of business counseling programs, to ensure effective oversight and management of entrepreneurial development programs and grants, and to meet Congressional and Executive Branch reporting requirements. The form should be submitted at the site of service to the counselor providing the service. Resource partners will submit information to SBA according to the terms of their notice of awards.

  

Public reporting for this collection of information is estimated to be 5 minutes per response, including the time for reviewing instructions, and completing and reviewing the collection of information. All responses to this collection of information are voluntary, and will be provided confidentially to the extent allowed by law. Notwithstanding any other provision of law, no person is required to respond to, nor shall any person be subject to a penalty for failure to comply with, a collection of information subject to the requirements of the Paperwork Reduction Act unless that collection of information displays a currently valid OMB control number. Send comments regarding the burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to the Reports Clearance Officer, International Trade Administration, Department of Commerce, Room 4001, 14th and Constitution Avenue, N.W., Washington, D.C. 20230.

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  Notice to Visitors!


  The link you have chosen will take you to a non-U.S. Government website.

  If the page does not appear in 5 seconds, please click this: outside web site

  BuyUSA.gov is managed by the International Trade Administration and external links are covered by its website disclaimer statement.