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Request for Scholarship & Agreement Form

If your business is one of the following zip codes, we may be able to pay for your registration: 97070 - 97140 - 97132 - 97137 - 97303 - 97115

We hope you enjoy the class or workshop and find the information valuable to your business. After you've filled out this form, we will make arrangements to register and pay for your class.

We appreciate your feedback on this workshop and will send you a brief evaluation after it has concluded. If you feel we should know something sooner, please reach out to us at this email address: BRC@wilsonvillechamber.com or call 503-682-0411 x4.

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Email *
Business Name *
Business address *
Contact person *
Contact phone number *
Title of the class or workshop you wish to attend: *
Cost of the class or workshop *
Date of the class or workshop (if this is a series, enter the first class date): *
MM
/
DD
/
YYYY
Describe briefly how COVID has impacted your business: *
How will this class or workshop help your business? *
Is your business a Minority, Woman, or Veteran-owned business? (51% ownership required) - Check all that apply. *
Required
As the owner (or representative) of my business, I agree to the following: *
Required
By my first and last name and date below, I agree to the items listed above.
 *
Date *
MM
/
DD
/
YYYY
A copy of your responses will be emailed to the address you provided.
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