Networking and Cohort Registration Form
Client Details:
Full Name
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
E-mail
example@example.com
Are you a Florida resident?
*
Please Select
Yes
No
Are you Active Duty within 12 months ETS, National Guard, Veteran, Veteran spouse (or unremarried Veteran spouse?
*
Please Select
Active Duty within 12 months ETS
National Guard
Veteran
Veteran Spouse or un-remarried Veteran Spouse
If a Veteran, what was your discharge status?
*
Please Select
Honerable
Medical
Dishonerable
Bad Conduct
N/A
If Veteran, Spouse, or un-remarried former spouse of Veteran, do you have copy of DD214?
*
Please Select
Yes
No
Are you an entrepreneur with a for-profit idea, startup business, or established business and a need to test your risks and assumptions for a new product or service?
*
Date of Birth
-
Month
-
Day
Year
Date
What events will you be attending
Networking 3/6/25 5pm-7pm COLAB - 418 W Garden St, Pensacola, FL
Networking 3/8/25 9am-11am COLAB - 418 W Garden St, Pensacola, FL
Getting started Cohort 3/24/25 - 4/17/25
Business Canvas Model Cohort 4/21/25 - 5/15/25
Additional information you'd like us to know or questions you might have:
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