MBDA CAPACITY BUILDING CERTIFICATE PROGRAM REGISTRATION

M. Gill/MBDA CAPACITY BUILDING CERTIFICATE PROGRAM REGISTRATION

Please complete this REGISTRATION in order to be considered for participation in the M. Gill/MBDA Capacity Building Certificate Program. ANSWER ALL QUESTIONS.
1. Name of Business
2. Business Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
3. Type of Business (Choose One)

Other
4. Please Check All Applicable Certifications
If Other Certification Not Listed Above is Selected – Please list here:
5.    Owner participating in the program

a. Name:  First Name*   Last Name*
b. Percent (%) Ownership in the participating businessNumber*%
c. Telephone: Area Code*   Phone Number*  Email: Email*
6. Non-Owner (Designated Participant if not Business Owner)

a. Name: First Name Last Name Position Title: Title
b. Telephone: Area Code Phone Number Email: Email
7. Annual Business Sales (Select one)
Participants are required to register as an MBDA Client upon Completion of the Capacity Building Program
8. Do you agree to register as an MBDA Client to receive No-Cost Technical Assistance Services?
9. Do you agree to participate in the entire 9-hour course?
10. Official Business Owner Or Designated Participant’s Signature
Date

MonthDayYear
Date
Graduates of the M. Gill/MBDA Capacity Building Program will receive:

1.     A Certificate of Completion

2.     Access to Financial Investment Opportunities

3.     Access to New Contracting Opportunities

4.     Access to New Local and International resources for Business Growth

5.     Ongoing, No-Cost Technical Assistance from the M. Gill/MBDA Team

6.     Potential Matchmaking Opportunities with Business Growth Professionals & Mentors
DISCLAIMER
- Program eligibility is determined by the MBDA Business Center – Operated by M. Gill & Associates, Inc.
- I understand that applying to this program will put me in consideration for other sessions, if I'm not selected for the most current.
- A complete Registration (with all questions addressed) is required.
- If you need further information, please contact us at admin@miamimbdacenter.com or 786-515-0670.
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M. Gill/MBDA CAPACITY BUILDING CERTIFICATE PROGRAM REGISTRATION

Participants are required to register as an MBDA Client upon Completion of the Capacity Building Program