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LGBTQ+ Entrepreneur Bootcamp Application
Name
(Required)
First
Last
Pronouns
(Required)
(Examples include: He/Him/His, She/Her/Hers, They/Them/Theirs)
Email
(Required)
Phone
(Required)
Have you already launched your business?
(Required)
Yes, we're up and running!
No, but we're ready to go.
Nope, we've got an idea but need some more help.
What industry/type of business have you launched/plan to launch?
(Required)
Why do you want to be a part of the LGBTQ+ Entrepreneur Bootcamp?
(Required)
What do you hope to gain from participating in the LGBTQ+ Entrepreneur Bootcamp?
(Required)
Resume
(Required)
Max. file size: 128 MB.
Please upload a current resume. This can also be emailed afterwards to phillip@wislgbtchamber.com.
What is your gender?
(Required)
Female
Male
Non-Binary/Third Gender
Prefer to self describe
Prefer not to disclose
Do you identify as transgender?
(Required)
Yes
No
Prefer not to say
What is your sexual orientation?
(Required)
Gay or Lesbian
Bisexual
Straight
Queer
Questioning
Pansexual
An identify not listed above / Prefer to self describe
Prefer not to disclose
Race/Ethnicity
(Required)
Hispanic or Latino: A person of Cuban, Mexican, Puerto Rican, South or Central American, or other Spanish culture or origin regardless of race.
Black or African American (Not Hispanic or Latino): A person having origins in any of the black racial groups of Africa.
White (Not Hispanic or Latino): A person having origins in any of the original peoples of Europe, the Middle East or North Africa.
Asian (Not Hispanic or Latino): A person having origins in any of the original peoples of the Far East, Southeast Asia or the Indian Subcontinent, including, for example, Cambodia, China, India, Japan, Korea, Malaysia, Pakistan, the Philippine Islands, Thailand and Vietnam.
Native Hawaiian or Pacific Islander (Not Hispanic or Latino): A person having origins in any of the peoples of Hawaii, Guam, Samoa or other Pacific Islands.
Native American or Alaska Native (Not Hispanic or Latino): A person having origins in any of the original peoples of North and South America (including Central America) and who maintains tribal affiliation or community attachme
Other
Prefer not to disclose
Terms and Conditions
I agree to the following terms:
I agree to the following terms:
1) All of the information that I have provided is true and accurate. 2) That if I am accepted into the program, to commit to being an active participant on September 14-15, 2023 in Milwaukee. 3) That if I am accepted into the program, I will pay the necessary registration fee of $50.
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