RAP Meeting
Wednesday, February 21, 2024
6:30 PM - 7:30 PM
 
First Name*
 
 
Last name*
 
 
Email Address*
 
 
Phone Number*
 
 
 
 
Business Legal Name*
 
 
What is your current business status?*
 
 
 
Street Address*
 
 
 
City*
 
 
 
State*
 
 
 
 
ZIP Code*
 
 
 
 
Business Address (if different from address above)
 
 
 
Business City
 
 
 
Business State
 
 
 
 
Business ZIP Code
 
 
 
 
Do you currently have any certifications? (select all that apply)
 
 
 
Do you have commercial/business insurance or a bond? (select all that apply)*
 
 
Have you had any city, county, state or federal government contracts?*
 
Yes
No
 
 
 
Please provide a brief description of your business.*
 
 
Are you interested in obtaining capital for your business?*
 
Yes
No
 
 
 
Gender*
 
 
 
 
Race*
 
 
 
 
If you selected mixed race, please indicate any of the following that you identify with.
 
 
 
Ethnicity*
 
 
 
 
As a 501(c)3 nonprofit – having information about who we serve supports our ability to demonstrate our impact and raise funding. Information that identifies you as an individual is secure and will never be shared with third parties without your consent.