Registration

Network Builder: A BIPOC Women's Business Cohort

Friday, May 31, 2024 10:00 AM to 11:30 AM Eastern

Location: CEI Women's Business Center South Suite 201

11 Open Seats

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Business Name	Leave blank if you do not have a name chosen or the business name is the same as your name.
Address	Your physical street address (number and street) of the business. If a home based business, or the business has not started yet, use your home address.
Address Line 2	Optional. Use for additional address postal information like apt, floor, suite, etc., or a PO Box.
City
State

Please answer the following demographic questions about yourself.

Race	Asian Black or African American North African Middle Eastern Native American/Alaska Native Native Hawaiian/Pacific Islander White Prefer not to say Other Check any that apply
Hispanic Ethnicity
What is your preferred spoken/written language?
Gender
Do you have preferred pronouns?
LGBTQ
Disability	Do you consider yourself a person with a disability
Military Status
Branch of Service

Business Status

Business has started

Check if you have started conducting business. Leave unchecked if you are in the planning stages and have yet to start this business.

Since this business has started, please enter the following information.

Year Started	Year this business started
Month Started	Month this business started
Business Type	Primary category of business
Female Ownership %	% Enter the percent female ownership for this business.
Business Online	Yes If business is conducted online
Home Based Business	Yes If business is home based
8(a) Certified	Yes If you are currently 8(a) certified.

Business Organization

Legal entity of the business

Employees FT

Current Number of Full Time Employees

Employees PT

Current Number of Part Time Employees

Annual Sales $

Annual Sales $ for the most recent full business year

Are you currently exporting

Yes

Funded in part through a Cooperative Agreement with the U.S. Small Business Administration.
All opinions, conclusions, and/or recommendations expressed herein are those of the author(s) and do not necessarily reflect the views of the SBA.

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First Name
Last Name
Zip Code	Enter your 5 digit Zip Code. If you don't have one or don't know your zip code, enter 00000

Primary Phone	The best phone number (with area code) to reach you during our standard business hours. Include extension if necessary.
Primary Phone Type	Type of the primary phone above

Web Site	Web site URL for the business
Business Description	Brief three to five word description of the business