Cox Communications Small Business Leadership Academy

Strome College of Business, in partnership with Cox Communications, is providing education and
strategies to help your business grow.

Name Name * First Last
Email *
Work Phone Work Phone * - ### - ### ####
Job Title *
Company/Organization *
Company Address Company Address *
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Form of Business *

Form of Business LLC C-Corp S-Corp Other Other
Year Founded *
Number of Employees *
Sales Range *

Sales Range Below $500,000 $500,000 - $1,000,000 $1,000,000 - $5,000,000 Above $5,000,000
Are you a certified Small Business Enterprise? *

Are you a certified Small Business Enterprise? Yes No
ODU’s College of Continuing Education would offer participants 3.6 continuing education (CE) credits for attending the program for a fee of $40. Would you like to receive the continuing education (CE) credits? *

ODU’s College of Continuing Education would offer participants 3.6 continuing education (CE) credits for attending the program for a fee of $40. Would you like to receive the continuing education (CE) credits? Yes No
Company Website *
Describe your business: *
Why do you want to participate in the Academy? *
How will the Academy help you reach your business goals? *
Please list some challenges/opportunities facing your company: *
How did you hear about this program? *
Please upload a professional resume

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