Please complete the following form and click to submit: Personal Information* indicates required field Full Name * Cell Phone * Maricopa Email * Student ID - last 4 only * Business Information* indicates required field Please provide a brief description of your (proposed) business venture Understanding & Acknowledgement By clicking submit at the end of this form, I understand and agree to all of the following terms: I am currently enrolled at Mesa Community College and I have been accepted into the Green Flag Program. I am a student who is African American, Latino, American Indian, low-income, first-generation, and/or a woman. If I am chosen, I am prepared to file legal paperwork to set up a viable business venture. I will remain enrolled at MCC for at least 24 months after being accepted into the Green Flag Business program. I will follow all program guidelines and actively participate and work towards building my business' financial independence within 24 months. If chosen for this grant, I understand that I will receive a maximum of $3,000 to be used for education expenses, business start-up expenses, legal fees associated with name registration, trademark registration and intellectual property protection, website development, annual website hosting, social media exposure, SEO, marketing, Mesa Chamber of Commerce membership fees and participation fees for Mesa Networking groups, events, and other business community events only. Please type your First and Last Name in the box provided. I understand that typing my name in this box constitutes a legal signature confirming that I acknowledge and agree to the above Terms of Acceptance.