LIBRERIA DEL PUEBLO - SEED PROGRAM INTEREST FORM ELIGIBILITY
Latino/a/Immigrant/Spanish Speaking/Undocumented Entrepreneur/Business Owners/Aspiring Business Owners
Name/Nombre
*
Last Name/ Apellido
*
Address/Direccion
*
City/Ciudad
*
State/Estado
*
Phone/Telefono
*
By providing your phone number you're consenting to receive communications from SEED Program which may include phone calls, text messages, and or emails. You may revoke this consent at any time by replying "STOP."
*
I consent to receive communications from SEED program or any of its representatives.
Email/ Correo Electronico
Type of Business / Tipo de Negocio
*
Name of Business / Nombre de su negocio
*
Nivel de clase
Basic
Intermediate
Self paced
How did you hear about us? / Como escucho de nosotros?
*
Word of Mouth / Referencia
Facebook
Seminar / Seminario
Other / Otro
Postal code
*
Preferencia de contacto
Text
Email
Llamada
Age Group
18-25
26-40
41-55
55+
Gender
Female
Male
Other
Income
Less than $25,000
$25,000- $50,000
$50,000-$75,000
+$75,000
Immigration Status
Social Security
ITIN #
None
Business Info
Brand New Business/ Negocio Nuevo
Established Business/ Negocio Establecido
How many employees/ cuantos empleados
0
1-3
3-5
5-10
10+
Submit / Someter