Tapestry Focus Group Registration Form

Welcome! Thank you for your interest in participating in AEO's focus group.

We look forward to learning more about you and your experiences as a Black business owner! Please fill out the following brief registration form to tell us a little about yourself and your business and to let us know your availability. Your responses to this form will be used only in preparation for our focus group and to ensure that each focus group has a variety of voices.

About Us:

The Association for Enterprise Opportunity (AEO) is the leading voice of innovation for microfinance and microbusiness. Our mission is to create economic opportunity for underserved entrepreneurs throughout the United States. We engineer transformational change through research, convening, incubation, and advocacy to foster a robust and inclusive market place.

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* 1. Are you a Black entrepreneur who owns a business that is currently in operation in the US?

Yes

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* 2. Please provide the contact information associated with your business.

Name *

Company *

Address *

Address 2

City/Town *

State/Province *

ZIP/Postal Code *

Email Address *

Phone Number *

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* 3. What is your business' website? If your business does not have a website, write in N/A.

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* 4. How many years has your business been in operation?

Less than one year

1 to 2 years

3 to 4 years

5 to 7 years

8 to 10 years

More than 10 years

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* 5. Including yourself, how many employees does your business have?

2 to 4

5 to 9

10 to 24

25 to 49

50 or more

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* 6. What was your business' annual revenue for the 2019 tax year?

Less than $15,000

$15,000 to $24,999

$25,000 to $49,999

$50,000 to $99,999

$100,000 to $299,999

$300,000 to $499,999

$500,000 to $799,999

$800,000 to $999,999

$1 million or more

My business did not earn revenue in 2019

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* 7. Have you ever received any external funding for your business (e.g. a bank loan, government grant, loan/donation from a friend or family member)?

Yes

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* 8. Have you ever received technical assistance for your business? This could activities including working with a mentor/business counselor, taking an in-person/online class, or seeking business guidance from a small business development center.

Yes

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* 9. What areas does your business currently operate in? Select all that apply.

Urban

Suburban

Rural

Online

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* 10. What is your race?

White or Caucasian

Black or African American

Hispanic or Latino

Asian or Asian American

American Indian or Alaska Native

Native Hawaiian or other Pacific Islander

Another race

Multiracial

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* 11. Do you identify with any of the following ethnic groups?

Black African

Black Caribbean

Black Latino/a/x

Black Hispanic

I prefer not to respond

Other (please specify)

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* 12. Were you born in the United States?

Yes

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* 13. What is your gender?

Male

Female

I prefer not to say

Other (please specify)

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* 14. How old are you?

Under 18

18-24

25-34

35-44

45-54

55-64

65+

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* 15. Select the focus group date/time that works best for your schedule.

August 27, 2020 from 3:00-4:30 pm ET

September 3, 2020 from 3:00-4:30 pm ET

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* 16. May we contact you in the future about other AEO work that could benefit from your expertise?

Yes