Community Economic Development Fund

We Teach Success Online Learning Registration

(* Denotes Required Fields)

Personal Information
First Name: *
Last Name: *
Your Title:
Business Name:
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 middle income households as those with aggregate earnings below $96,600. Do you consider yourself to be part of this group?:
Is the business you are associated with (Check all 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 CEDF?:
Select one:

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