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1871's Small Business Initiative
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Small Business Initiative Sign Up Form
Step 1 of 1
Please answer the following questions to sign up for mentor matching and more free resources.
First Name:
Last Name:
Date of Birth:
MM/DD/YYYY
How would you identify your gender?
Select An Answer
Female
Male
Non-binary
Not listed
I prefer not to answer this question
What is your preferred Pronoun?
Select An Answer
She/Her/Hers
He/Him/His
They/Them/Theirs
I prefer not to answer
How would you identify your ethnicity or race?
Select An Answer
American Indian or Alaska Native
Asian
Black or African American
Hispanic, LatinX, or of Spanish origin
Middle Eastern of North African
Mixed
Native Hawaiian or Pacific Islander
White
I prefer not to answer
Email:
Password:
WILL BE USED TO ACCESS THE SMALL BUSINESS INITIATIVE PORTAL
Mobile Phone Number:
Are you a small business owner?
Yes
No
Company Name:
Title at Company:
Company Website:
LinkedIn Profile:
WHAT IS YOUR BUSINESS'S ADDRESS?
Street Address:
STE/Unit #:
City:
State:
Zip Code:
Industry:
Select An Answer
Agriculture, Forestry, Fishing and Hunting
Construction
Manufacturing
Wholesale Trade
Retail Trade
Transportation and Warehousing
Information
Finance and Insurance
Real Estate and Rental and Leasing
Professional, Scientific and Technical Services
Administrative and Support, Waste Management and Remediation Services
Educational Services
Health Care and Social Assistance
Arts, Entertainment and Recreation
Accommodation and Food Services
Other Services
Please provide a brief description of your company:
How Many People Are On Your Team
Select An Answer
1-4
5-9
10-19
20-49
50-99
100-249
250 or more
What is your annual revenue?
Which devices do you use to support your business? Please select all that apply.
Laptop
Desktop
Smartphone
Tablet
How comfortable do you feel using technology to support your business?
Not comfortable at all
Somewhat comfortable
Very comfortable
How has your business been impacted by COVID-19?
Severely affected
Somewhat affected
Not affected at all
Please provide any relevant information on how you’re coping with COVID-19.
HOW DO YOU THINK SBI CAN HELP SUPPORT YOUR BUSINESS?
Is there anything else you would like our mentors to know before you meet with them?
Are you affiliated with a neighborhoood organization?
Select An Answer
LGBT Chamber of Commerce of Illinois
(ESDC) Eighteenth Street Development Corporation
Joseph Business School
LifeHouse Group
Build Bronzeville
Greater Englewood Chamber of Commerce
West Ridge Chamber of Commerce
University CoWork
Sunshine Enterprises
Onward Neighborhood House
Far South Community Development Corporation
(LVCC) Little Village Chamber of Commerce
Chicago Urban League
(PRCC) Puerto Rican Cultural Center
(IHCC) Illinois Hispanic Chamber of Commerce
Other
I am not affiliated with a neighborhood organization
How did you hear about 1871's Small Business Initiative?
