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Application for Membership to the Virtual Entrepreneur Network
To apply for membership into the Virtual Entrepreneur Network please complete this form. After clicking submit you will see a confirmation page and receive a follow-up email from Rural Business Innovation within 7 days.
*
Indicates required field
Name
*
First
Last
Email
*
Phone Number
*
Choose One
*
I have a business idea
I am in the process of forming my business
I have a fully formed business
Other
Company Name
*
Type "TBD" indicating (to be determined) if company is as of yet unformed/unnamed.
Industry Sector**
*
Agriculture
Diversified Manufacturing
Information Technology
Life Sciences and Biotechnology
Restaurant
Retail
Service
Healthcare Services
Professional Services
OTHER
Company Address (if none Home Address)
*
Line 1
Line 2
City
State
Zip Code
Country
Home address can be used, if operating your business from home or you are in the early stages of development with no physical location identified.
What do you hope to get out of being a part of the VEN?
*
What do you hope to get out of this business education session?
How did you hear about this program? (Optional)
*
Internet
Newsletter
Newspaper
Radio
Referral
Event
Other
If you answered, Referral, Event, or Other, please describe:
*
I agree to receiving marketing and promotional materials
Submit
** Disclaimer: RBI cannot support business solely operating in the areas of alcohol, tobacco, firearms, gambling, check cashing businesses, or adult entertainment.
Home
GETTING STARTED
Board Members
Sponsors
Services
Clients
LEAP
>
Application Process
Incubators
VEN
VEN APPLICATION
VEN Members Only
>
Welcome
Resources
Early Access Registration
News & Events
News
Training Workshops
Community Events
Contact
Employment