The CEI Women's Business Center: Request for Advising
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Thank you for your interest in receiving free, confidential advising from the CEI Women's Business Center.  After receiving this form we will contact you as soon as possible.
First and last name *
Phone number *
Email *
Street address (home) *
Town/City (home) *
Zip code *
Business name
(leave blank if none)
Position/title in business
e.g. owner/manager/etc. (leave blank if none)
Business website
(leave blank if none)
Business description *
Please write a brief description of type and stage of business or business idea.  
Business advising need *
Please describe what you are hoping to achieve through advising at the CEI Women's Business Center. This might include specific issues you are facing, goals you are working towards, questions you have, etc.   If you are filling out this form specifically to request credit counseling, please note that here.
Have you already been in contact with, or scheduled a meeting with, a WBC advisor?  If yes, please select with whom.  If not, leave blank.
Clear selection
Were you referred to us by MTI? *
Client Information
In order to keep our funders happy, and our advising free, we are required to ask this information.  We keep all information confidential, and report it only in aggregate.
Race *
Ethnicity *
Disability *
Gender *
Military Status *
Business Information
Business Status *
We define "in business" as having some online or physical business presence, and already having had paid sales.
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