compete for level. Terms & Conditions. Account Creator 1. Name First Name: Last Name: showcase page: Yes No

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1 2016 FARM BUREAU RURAL ENTREPRENEURSHIP CHALLENGE APPLICATION Welcomee to the 2016 Farm Bureau Rural Entrepreneu urship Challenge. The Farm Bureau Challenge is the first national business competition dedicated to rural businesses related to agriculture. Rural entrepreneurs compete for $145,000 in cash prizes to help the winning teams take their businessess to the next level. To apply for the 2016 Farm Bureau Rural Entrepreneurship Challenge, please complete the application below by June 30, Your entry into the 2016 Farm Bureau Rural Entrepreneurship Challenge is deemed acceptance of the Terms & Conditions. Visit the Challenge website to review the Terms & Conditions. Contact Information Account Creator The Account Creatorr (automatically entered below) is the main point of contact for this event. He/She will receive all corresponding s. 1. Name First Name: Last Name: 2. Address: 3. Phone Number: 4. Please re-enter your first and last name exactly as you would like it to appear on the public showcase page: 5. Do you have a team member? Yes No 1

2 6. Team Member First and Last Name 7. Company name: Eligibility Requirements 8. Are you a paid employee of Farm Bureauu at the county, state or r national level or one of Farm Bureau s affiliate companies such as AAIC or Farm Bureau Bank? Yes - Because you answered YES to the question above, you are not eligible to compete in the Farm Bureau Challenge. No 9. Are you an adult at least 18 years of age? Yes No - Because you answered NO to the question above, you are not eligible to compete in the Farm Bureau Challenge. Youu must be at least 18 years of age to be eligible for the Farm Bureau Challenge. 10. Are you a current Farm Bureau member? Yes No - Because you answered NO to the question above, you are not eligible to compete in the Farm Bureau Challenge. Youu must be a current Farm Bureau member to be eligiblee for the Farm Bureau Challenge. i. To be eligible for the Farm Bureau Challenge, join your county Farm Bureau AND enter your membership information in your application by the June 30, Learn how to become a Farm Bureau member in your state by visiting the American Farm Bureau website. 11. Membership Information Name on membership (i.e., individual name, family name, business name): Membership number: County: 12. Rural communities are defined as counties with less than 50,0000 residents or towns with less than 2,500 residents. This definition comes from the U.S. Census Bureau. Your business or primary residence must be located in a rural community in the United States to be eligible for the Farm Bureau Challenge. 2

3 Is your business or primary residence located in a rural community in the United States? Yes No - Because you answered NO to the question above, you are not eligible to compete in the Farm Bureau Challenge. Your business or primary residence must be in a rural community to be eligiblee for the Farm Bureau Challenge. 13. Where is your business or primary residence located? City: County: State: Company Description 14. Is your company a for-profit business? A for-profit business is defined as an organization that exists primarily to generate a profit, that is, to take in more money than it spends. Yes No - Because you answered NO to the question above, you are not eligible to compete in the Farm Bureau Challenge. Your business must be a for-profit business to be eligible for the Farm Bureauu Challenge Is your business related to agriculture? Yes No - Because you answered NO to the question above, you are not eligible to compete in the Farm Bureau Challenge. 16. Choose the agricultural area that best fits your business. Agriculture production Harvesting, processing and/or storage of agricultural products Transportation and/or logistics of agricultural products Sales and/or marketing of agricultural products Retail distribution and/or wholesale distribution of agricultural products Agritourism Support services My business is related to agriculture in another way. 17. How long has your business been in operation? 0 to 3 years More than 3 to 5 years More than 5 to 10 years 3

4 More than 10 years 18. What is the development stage of your business idea? Idea (still on paper) Research (trying to understand feasibility) Product development (proof of concept completed) Prototype (first version of product complete) Sales (actual customer revenue) 19. Company Description Describe your company in three sentences or less. This description will be used in the public showcase and promotional materials. (250 characters with spaces or less) 20. Picture Upload one picture that highlights you and your business. Pictures should be horizontal (landscape), not vertical (portrait). This description will be used in the public showcase and promotional materials. We do not allow logos, head shots or individuals under 18 years of age. Choose File: Businesss Plan: Overview 21. Problem & Solution What problem are you trying to solve? Who iss affected by this problem (target audience) )? How does your company s product or servicee solve the problem for your target audience? (1500 characters with spaces or less) 22. Competition What other companies are trying to solve thee problem today? How are you differentiated from the competition? Are you better, faster, cheaper, etc.? How have you protected your intellectual property from your competitors (i.e., copyright, patent, trademark)? (1000 characters with spaces or less) 23. Plan for Growth How will you use the $30,000 startup funds too advance your business idea if you win the Challenge? (10000 characters with spacess or less) 4

5 24. Business Team Describe the relevant experiencee of up to three team members in your business (500 characters with spaces or less for each team member). 25. Please indicate the number of employees in each category. You may select all three, or as many as applicable. How many people are employed by your business annually? Full-time Part-time Seasonal 26. Personal Story Describe your background and why you decided to start characters with spaces or less) your business. (500 Businesss Plan: Financials 27. Business Metrics Please provide the following economic indicators for r your business. Enter 0 for any of the fields below you cannot answer. Download Businesss Metrics Background for definitions, equations and examples of the metrics listed below Revenue ($): 2013 Revenue ($): 2014 Revenue ($): Revenue growth (%): Customer retention rate (%): Customer acquisition cost ($): Existing contracts ($): Gross profit margin (%): Please explain any situations or circumstances that may have affected the above business metrics. (500 characters with spaces orr less) 5

6 28. Financial statement (optional) Download, complete and upload the Balancee Sheet (excel file). The balance sheet template file was developed through the SCORE program, a program sponsored by the U.S. Small Business Administration. Learn more about completing the balance sheet by visiting the SCORE website. Choose File: Video Pitch 29. Video URL Enter the URL for your YouTube video pitch: Videos should be 5 minutes or less. Upload your video to YouTube as a nonbut be sure the private video. You can designate the video ass Unlisted if you wish, video is not Private. 6