NMBC Global

TNJ/NMBC ENTREPRENEURSHIP BOOT CAMP

REGISTRATION FORM FORM

Print and fill out this page, then mail back to NMBC with your payment
or pay online and fax this form to (212) 693 5048.

Name _____________________________________________________________________________

Company Name _____________________________________________________________________

Address ___________________________________________________________________________

City _______________________________________________ State______ Zip _________________

Phone _______________________________Mobile ________________________________________

Fax _________________________________eMail _________________________________________

Number of hours per week I can devote to my business _________

Average number of hours per day on the computer __________

Comfortable using/navigating Google and other search engines Yes_____ No_____

Have an operating business/project Yes ______ No ______

If operating, number of employees __________

Most of my business exposure has been in:

Retail ____
Service ____
Manufacturing ____
Public Service ____
Other (Specify) ________________________________________________

No of hours of regular exercise per week _____________________

How did you hear about the NMBC Entrepreneurship Boot Camp ____________________

Payment: $150.00 (Options)

(1) Make your payment using the PayPal button below them fax this completed Registration form to (212) 693 5048

(2) By check, mail this completed Registration Form and a check to:

National Minority Business Council, Inc.
Entrepreneurship Boot Camp
120 Broadway, 19^th Floor
New York, NY 10271

(3) Other (Specify) _________________________






				TNJ/NMBC ENTREPRENEURSHIP BOOT CAMP REGISTRATION FORM FORM Print and fill out this page, then mail back to NMBC with your payment or pay online and fax this form to (212) 693 5048. Name _____________________________________________________________________________ Company Name _____________________________________________________________________ Address ___________________________________________________________________________ City _______________________________________________ State______ Zip _________________ Phone _______________________________Mobile ________________________________________ Fax _________________________________eMail _________________________________________ Number of hours per week I can devote to my business _________ Average number of hours per day on the computer __________ Comfortable using/navigating Google and other search engines Yes_____ No_____ Have an operating business/project Yes ______ No ______ If operating, number of employees __________ Most of my business exposure has been in: Retail ____ Service ____ Manufacturing ____ Public Service ____ Other (Specify) ________________________________________________ No of hours of regular exercise per week _____________________ How did you hear about the NMBC Entrepreneurship Boot Camp ____________________ Payment: $150.00 (Options) (1) Make your payment using the PayPal button below them fax this completed Registration form to (212) 693 5048 (2) By check, mail this completed Registration Form and a check to: National Minority Business Council, Inc. Entrepreneurship Boot Camp 120 Broadway, 19^th Floor New York, NY 10271 (3) Other (Specify) _________________________