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NAME:
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CITY:
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STATE: (please use 2 letter abbreviation)
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EMAIL:
*
PARENT NAME:
PARENT EMAIL (if different):
PARENT PHONE:
*
Where are you with your business?
Tell us about your business: what do you do? when did you start? why did you start it? what do you plan to do with your money? Where would you like to see your business go over the next few years?
What type of support do you need?
Check all that apply
