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* 1. First Name

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* 2. Last Name

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* 3. Email Address

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* 4. Do you have a host sponsor?

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* 5. Your Age

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* 6. Gender

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* 7. Race

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* 8. Are you Hispanic, Non-Hispanic

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* 9. Are you an enrolled member of a Federally Recognized Native American Tribe?

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* 10. Household Income

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

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* 12. What is your 5-digit zipcode?

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* 13. Which one of the following best describes this location?

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* 14. Business Name (if applicable)

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* 15. How many years have you been in business?

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* 16. How many people work at your business or organization?

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* 17. What Industry best describes your business?

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* 18. Do you feel comfortable using digital and online tools?

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* 19. Do you have a website?

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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? 

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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?

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

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

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