Application for Services Complete this form to allow Wildhorse Business Development Services to assist you in starting or improving your small business. If you have any questions, please call us at 541-966-1918 or send an email to firstname.lastname@example.org. There are three sections to this form. Please complete all three sections or we will not process your application. You also must agree to the Waiver on the last section in order for us to provide any assistance. We are excited to work with you! Step 1 of 3 33% Name*Please enter your first and last name. First Last Address*Please enter your personal address where we could contact you. Street Address City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Phone*Please enter the best phone number to contact you with.Email Ethnic BackgroundWildhorse BDS is a service to the Indian/Native American tribal community. Please indicate your ethnic background. Native American / Indian Alaskan Native Asian / Pacific Islander Tribal / Tribal Enrollment Number*Please enter the name of your tribe and your tribal enrollment number (if applicable).Disabled / Veteran StatusPlease indicate if you are disabled, a veteran who served in Vietnam or a veteran who served outside of the Vietnam era. Special consideration is available if you fall into one of these categories, so please let us know. I am disabled I am a Vietnam Era veteran I am a veteran who served other than in Vietnam Business InformationNow please describe the following information about your current or future business.Business name*What is/will be the name of your business?Do you have a written business plan?*Do you have a complete, up-to-date and WRITTEN business plan?YesNoDate business plan completedWhen was your business plan was completed and written up? Just select the first day of the month when completed if you don't know the exact day. Is your business already operating?*Please select whether or not your business is already operating (business license purchased, buying and selling, etc.).YesNot yet!Date your business startedSelect the date when your business began operating. Just select the first day of the month when completed if you don't know the exact day. Business WebsiteEnter the website address of your business (if applicable). Ownership of businessIs your business (or will your business be) owned by male or female or both? Special consideration is sometimes available under Equal Opportunity provisions.Solely male-owned businessSolely female-owned businessJoint male/female owned businessHome based business?*Is your business (or will your business be) operated from a home?YesNoNumber of FULL-TIME employees?*How many FULL-TIME employees are there currently for your business?None (yet!)1-5 employees5-10 employees10 or more employeesNumber of PART-TIME employees?*How many PART-TIME employees are there currently for your business?None (yet!)1-5 employees5-10 employees10 or more employeesType of business*Please select the category (one or more) that describes the goods/services that your business is/will be involved in. Retail (sell products to the public) Wholesale (sell products to other business) Service (sell services to the public or other businesses) Manufacturing (materially fabricate new products) Construction (build using existing materials) Agriculture (raising, growing, farming food) Other Referred to Wildhorse BDS byHow did you hear about Wildhorse BDS' services? Small Business Development Center (SBDC) Bank Radio Newspaper CTUIR website Nixyaawii Chamber Word of mouth (friend, family, etc.) Website / internet search Other How can we help you?In this section, please let us know which of our services you are interested in. Typically, we will wish to meet with you to let you tell us about your situation. Knowing what services you are requesting helps us match you up with the best fit of people and resources.Educational OfferingsCheck which classes or seminars you are interested in. Seminars / Workshops (see this section on our website for specifics) "Exploring Your Business Idea" (2-week pre-requisite for "Indianpreneurship") "Indianpreneurship" (award winning 10-week course) Counseling OfferingsCheck the areas of business assistance you would find helpful. Starting a new business Market Research Selling to Government Record-keeping and accounting Financial Analysis Inventory Control Engineering, R&D Personnel / Human Resources Business Plan Sources of Credit & Financing Business Liquidation/Sale Computer Systems / Website / Internet Advertising Purchasing Credit & Collections Other WAIVER*I am requesting business counseling service from Wildhorse Business Development Services. I understand that these counseling services are free of charge. In consideration of the furnishing of business counseling services to me or my company, I waive all claims arising in connection with this assistance against the Wildhorse Business Development Services, Wildhorse Resort & Casino, and The Confederated Tribes of the Umatilla Indian Reservation and their employees or representatives.Type your full legal name below to indicate your legal agreement to this waiver. You agree that typing your full legal name here is your Electronic Signature, with the full legal force of your handwritten signature.Type your full legal name here as your Electronic Signature:Date signedSelect the date this waiver is signed. This iframe contains the logic required to handle AJAX powered Gravity Forms.