2023 Women & Pride WBE Intake Form

Company Name *

Company Website*

Company Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

What is your primary industry?*

Based on Primary NAICS Code (as listed in WBENCLink2.0)

Year Business Established*

Is your company:*

Majority ProductsMajority ServicesBoth Products and Services

Are you currently WBENC-Certified and in good standing as a Women's Business Enterprise?*

YesNo

Regional Partner Organization (RPO)*

Please provide your WBENCLink2.0 System Vendor Number. *

To find your System Vendor Number: 1) Log into your profile in WBENCLink at www.wbenclink.org, 2) Click on your Certifications, 3) Your system vendor number is in the upper right corner

Please select all WBENC Programs you have participated in*

Are you currently Certified as an LGBTBE by the National LGBT Chamber of Commerce (NGLCC)?*

YesNoOther

Please provide a short company description (3-5 sentences) *

Please include your company's Instagram handle *

(N/A if you do not have one)

Please include your company's LinkedIn handle *

(N/A if you do not have one)

Please upload a high-resolution web version of your company logo *

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I understand that WBENC may or may not reach out for a follow up, and that completion of this form does not guarantee involvement within the Women & Pride program"*

I agree