First and Last Name:

Title: (ex. President, CEO, Founder)

Organization:

Are you the primary contact? yes no

Email Address:

Confirm Email:

Telephone Number:

Website:

Address1:

Address2:

City:     State:   

Zip:


Type of products/services that your business provides:



Is your business:

not-for-profit for profit


Type of service(s) you would be interested in receiving from the NCEC? (check all that apply)

graphic deisgn advertising web design marketing legal services

financial services business plan consulting

strategic planning human resources

risk management logistics operations planning

other:

Tell us a little about yourself:

UNCG student UNCG faculty/staff   UNCG alumni

non-UNCG student non-UNCG faculty/staff

Self Employed Retired

 Is there anything else you'd like us to know?       


    Note: You will not receive automatic email confirmation after submitting this form.

Thank You for your interest in the North Carolina Entrereneurship Center @ UNCG.
We'll be in touch!
As always, if you have questions or if you would like additional information,
please do not hesitate to contact us.