Pink Money Interest Form
Please fill out this form to the best of your ability. If you have questions about this form, email us at HeySis@PinkMoneyInc.org. Once your form is received we will follow up with the next steps.
Name
First Name
Last Name
E-mail
Phone Number:
-
Area Code
Phone Number
City, State, Zipcode
Age Range
Under 25
25-34
35-44
45-54
55-64
65+
Prefer not to say
Are you a mother?
Yes
No
Expecting (first time mom)
Select the option(s) that best describe your situation.
I am a woman entrepreneur needing business support.
I am woman currently unemployed and seeking employment.
I am a woman who is employed and looking to supplement my income.
I am a woman in need of general support.
What are you looking for?
Business Promotion (Pink Money Marketplace)
Mentorship (Pink Money Mentor Match)
Financial Education
Peer Support/ Community/ Networking
Something else
Resources and/or support (food, housing, transportation, rental/mortgage assistance, child care etc)
What is your biggest challenge right now?
How soon do you need support?
Immediately (Urgent)
Within the next 30 days
Just exploring
Have you worked with any other nonprofits, groups, or companies for support before?
Yes
No
If so, share:
Opt-in to Communications
Yes, I’d like to receive updates, resources, and opportunities from Pink Money Inc. via email. I know I can unsubscribe anytime — no hard feelings.
Accuracy Confirmation
I confirm that the information I’ve provided is accurate to the best of my knowledge.
Data Privacy Acknowledgement
I understand that the information I share will be used by Pink Money Inc. to connect me with relevant resources, track community impact, and improve our programs. My information will never be sold or shared with third parties without my permission.
Should be Empty: