CRA JVPP Informational Survey

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* 1. Please provide your first and last name.

First Name:

Last Name:

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* 2. Please provide the name of your entity/organization, if applicable.

Name of entity/organization:

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* 3. Please provide your address.

Street:

City:

Zip Code:

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* 4. Please provide the address of your entity/organization, if applicable.

Street:

City:

Zip Code:

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* 5. Please provide your telephone number, mobile number, and email address.

Work/Home number:

Mobile number:

Email address:

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* 6. What is your preferred method of contact?

Work/Home number

Mobile number

Email address

Written mail

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* 7. Select which group(s) you would like your information provided to. Please select all that apply.

Adult-Use Licensees

Potential Adult-Use Licensees

Those Seeking to Become Social Equity Participants

Anyone That Requests a Listing of Social Equity Participants Interested in Pursuing JVPP Opportunities

Question Title

* 8. Please select the county that you are most interested in working or operating in (you can select up to five (5) counties)?

Allegan

Arenac

Barry

Bay

Berrien

Branch

Calhoun

Cass

Eaton

Emmet

Genesee

Gratiot

Hillsdale

Ingham

Ionia

Isabella

Jackson

Kalamazoo

Kent

Lapeer

Lenawee

Macomb

Mecosta

Monroe

Montcalm

Muskegon

Newaygo

Oakland

Ogemaw

Ottawa

Roscommon

Saginaw

Shiawassee

St. Clair

St. Joseph

Tuscola

Van Buren

Washtenaw

Wayne

Wexford

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* 9. Please click here to download the JVPP authorization form. Once downloaded, please fill it out and email it to cra-socialequity@michigan.gov. Once you have emailed the authorization form, please click YES to continue.

Yes

Question Title

* 10. Which of the following JVPP partnerships interest you?
Please select all that apply.

Joint Business Ventures

Mentorships

Incubator Programs

Employment

Training

Funding

CRA JVPP Informational Survey

Question Title

* 1. Please provide your first and last name.

Question Title

* 2. Please provide the name of your entity/organization, if applicable.

Question Title

* 3. Please provide your address.

Question Title

* 4. Please provide the address of your entity/organization, if applicable.

Question Title

* 5. Please provide your telephone number, mobile number, and email address.

Question Title

* 6. What is your preferred method of contact?

Question Title

* 7. Select which group(s) you would like your information provided to. Please select all that apply.

Question Title

* 8. Please select the county that you are most interested in working or operating in (you can select up to five (5) counties)?

Question Title

* 9. Please click here to download the JVPP authorization form. Once downloaded, please fill it out and email it to cra-socialequity@michigan.gov. Once you have emailed the authorization form, please click YES to continue.

Question Title

* 10. Which of the following JVPP partnerships interest you?Please select all that apply.

* 10. Which of the following JVPP partnerships interest you?
Please select all that apply.