Jumpstart Membership 
How does Rock County Jumpstart help business owners?

Our organization assists Black and Latino small business owners in Rock County by providing them with access to free entrepreneurship resources and training. Our primary programming is on providing culturally competent, culturally relevant, and culturally sensitive services for business owners who self-identify as Black.  Please complete the intake form below to let us know how we can help start, grow, and scale your business.
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Email *
First Name *
Last Name *
Phone Number (Include Area Code) *
Do you currently operate a business? *
How long has your business been in operation? *
What is the name of your business? *
Is your business located in Rock County? *
Are you currently a Rock County, WI resident? *
Is your business 51% owned and operated by a person who self-identifies as Black? *
Is your business more than 51% owned AND operated by a person who self-identifies as Latino?
*
What type of goods/services does your business sell? *
Please provide a link to your website if you have one. *
Please provide a link to your Facebook page if you have one. *
Which of these other social media platforms do you use to promote your business? *
Required
Where do you run your business? *
What are the top 3 challenges you have running your business? (Choose up to three answers) *
Required
What have you accomplished for your business so far?
Have you received business assistance from any other service providers?
How much time per month are you able to commit to business training and one-on-one business coaching at Rock County Jumpstart
Do you have any additional comments or questions?
A copy of your responses will be emailed to the address you provided.
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