Community Economic Development Fund

You Gotta Know Your Numbers

(* Denotes Required Fields)

Personal Information
First Name: *
Last Name: *
Your Title:
Business Name:
Business Address: *
Address 2:
City: *
State: *
Zip: *
Daytime Phone: *
Email: *
Demographic Information
Please provide the following demographic information so we can better describe for our grant supporters the communities we serve. (Your information will be used in aggregate totals only.) 
What is your gender?:
The state of Connecticut defines low and moderate income as those with household income (AGI) below $99,700. Do you consider yourself to be part of this group?:
Is the business you are associated with (Check any that apply):
About how many years has the business you are associated with been in operation? (Please enter 0 if not yet operating):
Number of employees (Please count yourself):
How did you hear about this specific educational program?:
Select one:

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