Loan Application Form
Application for FarmWorks Loan
For questions or for assistance with the application please contact:
Linda Best, lbest@ns.sympatico.ca, phone 902-542-3442, cell 902-670-3660
Please email lbest@ns.sympatico.ca , or mail completed form to Linda Best, 70 Eden Row, Wolfville RR2, NS, B4P 2R2.
FarmWorks’ Mission is to promote, and provide strategic and responsible community investment for, food production and distribution in order to increase access to a sustainable local food supply for all Nova Scotians. Applications are invited from Nova Scotian entrepreneurs who are seeking funding for viable businesses in order to increase sustainable production of food and beverages. Submissions are the first stage of applications for capital from the money that FarmWorks has raised from investors in the Community Economic Development Investment Fund.
If you are completing the form in Word the spaces will expand to accommodate your response. If you prefer you may print the form and fill it in and mail or deliver it to Linda Best – see above.
General Business Information
| What is the name of your business? |
| What is your business address? |
| What is your business telephone number? |
| What is your business web address, if available? |
| What is the name of the person whom we should contact? |
| What is the contact person’s phone and cell phone number? |
| What is the contact person’s email address? |
Detailed Business Information
What is the type of your business?
____ Farm – Producer
____ Caterer / Prepared Foods
____ Specialty Food Item
____ Winery or beverages
____ Food Processing & Packaging – Beverage Production, Slaughterhouse, etc
____ Restaurant / Bar
____ Distribution
____ Marketing & Sales
____ Other
| If you checked “Other,” please indicate your business type. |
| What is your Vision and/or Mission Statement? |
| Describe your business in 1- 3 sentences – the brief or “Elevator” pitch that will persuade people to support your business. |
| Describe the new business, transition, expansion, increase in financial stability that you intend to achieve with the funding requested – your Funding pitch. |
What is the status of your business?
____Start Up
____Transition or Expansion
____Other
| If you checked “Other,” please indicate what your business status is |
| For Start Ups, What is your anticipated Launch Date? |
| For On-Going Businesses, how long have you been in business? |
What is the legal structure of your business? Either actual for on-going businesses or anticipated for start ups
_____Partnership
_____Limited Company
_____Sole Proprietorship
_____Co-operative
_____Have not selected of organized business structure yet
Do you have a business plan prepared?
____Yes
____No
____Under Development
Analyzing Your Business Model
| For current businesses, what are the various sources of your business revenue? |
| Describe the products and services that create value for specific types of Customer. What needs are you satisfying? What problem are you solving? |
| How do you establish relationships with your customers? What are the channels by which you communicate with and reach customers? Direct sales? Web sales? Wholesale? |
| Who are the key individuals and suppliers that your business relies on? |
| What is your most ambitious goal for your business? Please be specific. |
| What is your biggest challenge beyond financing? Please be specific. |
Financing Needs
| What is your projected increase in annual revenue from operations after the new plans are in effect? |
| How many more people are projected to work in your business after the new plans are in effect? |
| Approximately how much money do you need in addition to what is presently available to you? |
| Please explain how the money you are seeking will be used to achieve your goals. Will it increase your business revenue? |
| If this loan is not granted by FarmWorks could you adapt your business plan to achieve you goals? |
Principles of Sustainability
| How are you ensuring the sustainability of your business? |
| Do you collaborate with and / or support other local businesses? If so, please describe. |
| What does “local” mean to you? |
| Is your product, by your definition, locally made or made with local ingredients? Please describe. |
| Is your product certified by any agency or organization? |
| Please describe any other relevant sustainability practices of your business – Environmental, Energy, Labour, Trade, Access, Diversity, Soil Health, etc. |
Please attach any additional information you wish to provide