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1. First Name (Required.)

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2. Last Name (Required.)

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3. Email Address (Required.)

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4. Do you have a host sponsor? (Required.)

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5. Your Age (Required.)

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6. Gender (Required.)

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7. Race (Required.)

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8. Are you Hispanic, Non-Hispanic (Required.)

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9. Are you an enrolled member of a Federally Recognized Native American Tribe? (Required.)

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10. Household Income (Required.)

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11. Where are you based? (include your city/town and state) (Required.)

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12. What is your 5-digit zipcode? (Required.)

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13. Which one of the following best describes this location? (Required.)

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14. Business Name (if applicable)

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15. How many years have you been in business? (Required.)

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16. How many people work at your business or organization? (Required.)

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17. What Industry best describes your business? (Required.)

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18. Do you feel comfortable using digital and online tools? (Required.)

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19. Do you have a website? (Required.)

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20. If yes, please share your website link 

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21. If yes, what website platform do you use? 

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22. If no, are you planning to build a website in the future?  

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23. Do you use social media?  (Required.)

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24. What social media platforms do you use? (check all that apply)

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25. Do you have an email list? (Required.)

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26. Do you accept payments online through your website and/or through sites like Square or Paypal? (Required.)

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27. What digital skills do you want to learn about most in this program? (check all the apply) (Required.)

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