TCI Mastermind Enrollment Form
Our TCI Mastermind meets weekly every Wednesday at 6 pm EST. The first Introductory Class 12/20/23 and the Mastermind starts on 01/10/24. Please fill up this application to be considered to be part of this Mastermind.
Name
*
First Name
Last Name
Phone Number
*
Email
*
Date of Birth
*
-
Month
-
Day
Year
Date
Address
*
Street Address
Street Address Line 2
City
Please Select
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
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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
Branch of Service?
Please Select
Army
Marine Corps
Navy
Airforce
Coast Guard
National Guard
Are you currently serving in the U.S. Military?
Yes
No
Do you expect and Honorable Discharge?
Yes
No
Please explain why you are not going to receive an Honorable Discharge.
*
Do you currently own and operate a business?
Yes
No
Please Provide a name and description of your Business(es).
*
List 2 or more ideas for starting a business:
*
Are you separated from the U.S. Military
Yes
No
Attach your DD-214 to this form AND black out your SSN
*
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How did you hear about The Clark Initiative?
*
VFW or American Legions
Word of Mouth
Social Media
Internet
Another Non-Profit
Other
What is the Name of the Non-Profit who referred you over?
Note: You are required to sign up for an interview and to watch the onboarding call upons submission of this application. No application will be accepted in full until both of these requirements are met. Hitting the submit button will redirect you to the associated links
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