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BreakOut Program
for small businesses ready to move to the next level

A project funded by the US Department of Agriculture
Rural Development Office

2012 BreakOut Application


Company Name:  
Contact Name:  
Company Mailing Address:  
City, State, Zip:     
              City                   State          Zip
County:   
Telephone:  
Email Address:  
Is your organization a private company? Yes
No
Do you have two or more, but less than 50 employees? Yes
No
Are your annual gross revenues $1M or less? Yes
No
Not sure  (see guidelines)

 

Please share your company history.



Where do you want to go as an organization?




What do you hope to get out of this program?



What do you see as your biggest weakness as a business?



What is your biggest challenge at this point?



What intrigues you about the BreakOut Program?





What concern(s), if any, do you have about being a BreakOut Program participant?



Would you like to share anything else?



Do you have any questions you would like to discuss?

 

Certification:

By submitting this application, I certify I meet all the USDA and USI requirements for participation in this project, and that, if selected, my company can invest $1,500 toward the process.  In addition, my management team will commit no less than two working days to the strategic planning process, as well as other time necessary to work with the project consultants.


 

Gross Revenue Guidelines: 
(click here to return to form)

  • Gross revenue is defined as revenue of a business before deductions for any purpose, except for sales returns.

  • In the case of a manufacturing or merchandising business, gross revenue means gross profit (i.e., gross sales or gross receipts less cost of goods sold.

  • Revenue for a given period consists of the inflow of cash and receivables from sales made in that period.

  • Also, earnings on investments, such as interest earned on a bank savings account or on a Government bond and the dividends received through ownership of capital stock, are part of the gross revenue.



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