1 Million Black Business Initiative (1MBB) - Intake Form

Thank you for your interest in Operation HOPE's small-business initiative to support aspiring black entrepreneurs and small-business owners across the country. To better serve you, we need to gather additional information.

Please answer the below questions as thoroughly as possible. Your answers will remain confidential and will not be shared with anyone outside of the 1 Million Black Business Initiative. For any questions or concerns, please email us at: 1MBB@OperationHOPE.org.

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* 1. Please provide the following information.

First Name

Last Name

Mobile Phone Number

Email Address

Postal / Zip Code

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* 2. Were you Referred to 1MBB by a HOPE Partner?

Yes

Unsure

If you were referred by a 1MBB partner, please type in your referral code, below:

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* 3. What is your Race / Ethnicity?

Black or African American

White or Caucasian

Hispanic or Latino

Asian or Asian American

American Indian or Alaska Native

Native Hawaiian or other Pacific Islander

Another race

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* 4. What is your gender?

Male

Female

Transgender

Non-Binary

Other

Prefer not to answer

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* 5. What is your education level?

Some High School

High School Graduate or GED

Some College

Associate's Degree

Bachelor's Degree

Advanced Degree (Master's, Professional, Doctorate)

Other

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* 6. Please select your age range from the options below.

18-24

25-35

36-50

51+

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* 7. What is your entrepreneurial passion?

I want to start a new business.

I want to grow my existing business.

My existing business needs specific help (e.g. accounting, web development, marketing, etc.)