Longer Intake Form for Vancity UWEP

Name(Required)

First Last

Phone(Required)

Email(Required)

Business Name(Required)

City(Required)

Did you receive financing from Vancity as part of the Unity Women Entrepreneurs Program?

Yes, a line of credit

Yes, a term loan

My application is still in progress

Prefer not to say

How long have you been in business?(Required)

Pre-Startup – I have not started my business yet

Startup – In business less than two years

Growth – In business two years or more

Which types of support are you looking for?(Required)

You may select as many options as you’d like.

Use this area to provide us with more information

For statistical purposes

Please indicate if you are…(Required)

Immigrant

Indigenous

Person with Disability

Youth (under 30)

None of the Above

Prefer Not to Say

If you are an immigrant, please indicate how many years you have been a permanent resident of Canada.(Required)

Age

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Welcome to the Unity Women Entrepreneurs Program!

For statistical purposes