Money Smart For Small Businesses TOOL UP SBA CURRICULUM – COMING MAY 2023, TBA TOOL UP SBA CURRICULUM – COMING APRIL 2023, TBA "*" indicates required fields Step 1 of 3 33% Today's Date MM slash DD slash YYYY Name* First Last Email* Phone*Preferred Method of Contact*Please select all that apply. Email Phone Letter Other List other preferred method of contact Address* Street Address City State / Province / Region ZIP / Postal Code Date of Birth Month Day Year Gender* Female Male Prefer not to answer Race* American Indian / Alaskan Native Asian Black / African American Hispanic / Latino Native Hawaiian / Other Pacific Islander White Other Prefer not to answer Marital Status* Married Domestic Partner Single (never married) Separated Divorced Widowed Are you a Military Veteran?* Yes No Prefer not to answer Disability* Yes No Prefer not to answer Highest Level of Education?* Less than High School High School Diploma / GED Some College Technical School graduate or technical certification Two-Year Degree Four-Year Degree Masters Degree Doctorate Degree What is your household size?*Number of people including yourself.What is your gross annual income?*What is your credit score?*MBCDC Program Interest*Please check all that apply. Community Education Financial Literacy Homeownership Homeowner Repair Individual Development Account (Savings Program) Small Business Volunteer Yes - Youth Employment Services (16 - 24) Other List Other Program Interest Below Have you ever been arrested?* Yes No I hereby transfer and grant the Martindale Brightwood Community Development Corporation ("MBCDC") the exclusive right to use and authorize others to use all or any part of my (his/her) interview/photograph/video in related media such as books, newsletters, flyers, magazines, journals, pamphlets, electronic (Internet) and other written and video formats. I also hereby release MBCDC and its directors, members, trustees, officers, employees, and agents from any and all claims, demands, causes of action and suites, including but not limited to, claims for invasion of privacy, defamation, breach of contract or other breach of duty arising out of of in connection with the use of this interview, photo, or video.* AgreeI hereby certify that the information included on this form is correct to the best of my knowledge and that such information may be subject to verification by representatives of Martindale Brightwood CDC for purposes of meeting requirements for a program.* Agree
