Apply for a loan.

Are you in Grade School or High School?


What school do you go to?

Name of your mentors


For application confirmation

Business name

Ex: EcoChalk

Member names

(Comma seperated please.)

Business description

(What is the product or service you are offering? This should be a mini-pitch of your

Ex. We create chalkboards out of recycled wood pallets, and homemade chalkboard paint. We gather the wood pallets from the Windsor dump. We get our
supplies to create the chalkboard paint from Oliver’s Organics. We then paint the
old pallets and give them a new life as a chalkboard!

Cost breakdown

(What are the individual prices of all materials and equipment that will be used to start
your business.)

Ex. Recycled wood pallets- $0
Paint - $12
Grout - $20
Paint brushes- $10

Total cost

(This will be the estimated total cost of your start-up)

Ex. 0+12+20+10= $42

Estimated per-unit cost

(For each unit, determine the cost of your product. This is necessary in order to know
how to properly price your product. This figure will most likely be a rough estimate until
you physically assemble the product)

Ex. With the total cost of materials, we can produce 7 products:
Cost per Unit = Total Costs = $42 = $6/unit
# of products produced 7
Therefore, cost per unit is $6/unit


(How many products/services do you need to sell in order to break-even?)

Ex. Total Costs to Start Your Business
Selling Price
Where our selling price per unit is $10
$42 / $10= 4.2 units

Projected revenue

(Selling price per product x projected amount sold. State how many units you wish to sell
and your unit selling price)

Ex. Selling price= $10
Sales goal in units is 30 units
$10 x 30 units = $300

Green tax break

(Say which of the 4 R’s you believe your business has satisfied that justifies the 4 R
requirements: 3 out of the 4 R’s justify for 7% tax break***)

Ex. Reuse: We reuse wood pallets from the Windsor dump that would’ve gone to waste
Recycle: We recycle any materials that cannot be used in any way
Reduce: We reduce waste by packaging our product in 100% recycled materials,
ensuring plastic and other items are not being produced and thrown in landfills after

Funds requested

(Only ask for amounts that will cover initial costs. Funds must be requested in $25
intervals. I.e. $25/$50/$75/$100)

Ex. $50 as this will cover initial costs of production of $42

Approved by a Youthrive Mentor?