Believe In Your Business 2023-2024 Registration Form

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All students are welcome to join Believe In Your Business, no matter what stage you are in on your entrepreneurial journey. You could be just curious about what entrepreneurship is like, you could have an idea for a business, you could be planning a business, or you could have launched a business.
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Student Name* This field is required.
First Name
Last Name
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Student Email* This field is required.Personal email preferred. School email is okay if you don't have a personal email.
example@example.com
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Student Phone Number* This field is required.Please add your parent's phone number, if you don't have one.
Area Code
Phone Number
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Address* This field is required.
Street Address
Street Address Line 2
City
Please Select
Please Select
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
Please Select
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
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School Name * This field is required.
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Grade Level* This field is required.BIYB serves primarily high school students, but those younger or older may be considered on a case by case basis.
Younger than high school
9th grade
10th grade
11th grade
12th grade
Older than high school
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Business Name OPTIONAL - Only if you operate a business.
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Type of businessOptional - only if you operate a business.
Side gig
Nonprofit
Small local or online business
Large scalable business
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Market of your businessOptional - only if you operate a business.
Technology
Food
Arts
Retail
Social Impact
Services
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Stage of your business
I am just curious about entrepreneurship
I have a business idea
I am working on a plan for my business idea
I've launched! No sales yet, but I am actively talking with possible customers or actively developing a product/service
I've got sales!
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What age were you when you started your business?Optional - only if you operate a business.
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T-Shirt Size* This field is required.
S
M
L
XL
2XL
3XL
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Date of Birth* This field is required.
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Gender* This field is required.For demographic purposes only.
Female (she/her)
Non-binary (they/them)
Male (he/him)
Prefer not to say
Other
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Race/Ethnicity* This field is required.For demographic purposes only.
American Indian / Alaska Native
Asian
Black / African American
Hispanic / Latino
Native Hawaiian / Other Pacific Islander
White / Caucasian
Mixed / Multiracial
Prefer not to say
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Annual Household Income* This field is required.Household income means the the total amount of money earned annually by your parents together with you or anyone else in the family who has a job. Your best estimate off of the top of your head is fine. We never release your family’s personal information. We keep it confidential, but some grant applications ask us for group percentage statistics for the people we serve.
Less than $15,000
$15,000 - $24,999
$25,000 - $34,999
$35,000 - $49,999
$50,000 - $74,999
$75,000 - $99,999
$100,000 or more
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Does the student have any intellectual, developmental, or physical disability?* This field is required.CONFIDENTIAL - For grant purposes only.
Yes
No
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If Yes, please specify.CONFIDENTIAL - For grant purposes and/or any necessary accommodations.
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Please list any medical conditions/allergies.CONFIDENTIAL - For medical emergency purposes only.
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Please list a preferred hospital.CONFIDENTIAL - In case of medical emergency.
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Parent/Guardian Name* This field is required.
First Name
Last Name
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Parent/Guardian Phone Number* This field is required.NOTE: Parent/guardian will be considered Emergency Contact by default. If you would like to add an additional emergency contact, please list name, phone number, and relation to the individual in the Message section of this form.
Area Code
Phone Number
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Parent/Guardian Email* This field is required.
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How did you hear about Believe In Your Business?* This field is required.
Steve Franks (Program Director)
Social Media
A Friend or Family Member
School or Teacher
Other
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MessageOPTIONAL: Please share any additional thoughts or questions you may have.
Should be Empty: