Training Application Form

1,000 Black Creators Initiative By Black Nerd Swag Signup

Participant Registration Form
Name: *

First Name Last Name
Company Name *
What is your Business? *
Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country
E-mail *
List the social media accounts for your business. Enter your website or ecommerce website if you have one. *
Cell Number *
When it comes to marketing and selling your services or products online what is your single biggest challenge? Please be as detailed as possible so we can assist with that in the program. *
Do you currently sell online? *

Yes No
How do you currently sell your stuff? *
Is it important to you as a Black Creator to be able to grow your business? *

Yes No
This Program is for Black Creators Only. Are you Black? *

Yes No (If no there is a separate program launching later in the year. Standby for that announcement.)
Should be Empty:

1,000 Black Creators Initiative By Black Nerd Swag Signup