BUSINESS COHORT REGISTRATION
Your Name
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Race
*
African American
Caucasian
Hispanic
Other
Gender
*
Female
Male
Date of Birth?
*
-
Month
-
Day
Year
Date
Contact Number
*
E-mail
*
example@example.com
BUSINESS INFORMATION SECTION
Business Name
*
Do you have an business partner(s)
*
Yes
No
If yes, Business Partner Name
First Name
Last Name
What Industry are you interested in?
*
Please Select
Nonprofit Organization
I.T. Information Technology
Accommodation and Food Services
Administration, Business Support and Waste Management Services
Agriculture, Forestry, Fishing and Hunting
Arts, Entertainment and Recreation
Construction
Educational Services
Finance and Insurance
Healthcare and Social Assistance
Manufacturing
Mining
Other Services (except Public Administration)
Professional, Scientific and Technical Services
Real Estate and Rental and Leasing
Retail Trade
Transportation and Warehousing
Utilities
Wholesale Trade
Advisory and Financial Services
Business Franchises
Consumer Goods and Services
Industrial Machinery, Gas and Chemicals
Online Retail
Retail Store
Specialist Engineering, Infrastructure and Contractors
Technology
What type of business do you have?
*
Sole Proprietorshipp
Partnership
L.L.C. (Limited Liability Company)
S Corporation
None of the Above
Is your business?
*
An idea
Just Started
Operating 1 - 5 years
5 or more years
Do you have an EIN Number ( Employee Identification Number) given by the IRS (Internal Revenue Service)
*
Yes
No
No, I don't need one
I plan to get one
Are you available?
*
1 day a week
1 once every two weeks
1 once a month
Upload a Recent picture?
What specific goals or objectives do you hope to achieve by participating in this business cohort program?
*
How do you envision this cohort program benefiting your business or entrepreneurial journey?
*
Upload your profile picture.
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BUSINESS CHECKLIST
Do you have a business plan?
*
Yes
No
Do you have a marketing plan?
*
Yes
No
Do you have a website?
*
Yes
No
Does your business have a logo?
*
No
If yes, please provide domain (for example; google.com, myshirt.net helpme.org...etc)
What Do You Need from Us?
Cohort Agreement
COMMUNICATION - I understand that all communication, including correspondence regarding the cohort costs, meeting time(s) and location(s), course drop deadlines, as well as payment information and receipts, will be conducted through the Western Tennessee A&M. I will check my email account regularly for correspondence from the School of Continuing Education. If you need assistance, please contact technical support at (901) 498-1342. Due to the hybrid nature of cohorts, where course length is varied in a given semester, punctuality is a necessity when enrolling, paying, or dropping a cohort course. ATTENDANCE- Attendance is mandatory for all courses in which the student is registered. Any exceptions must be approved by the instructor in advance unless it is an emergency that meets the guidelines of Western Tennessee A&M. Documentation may be required.
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