ATTENTION!
The Independent Advising program at SEG has been discontinued. Please
apply here
for SEG's business clinics.
Independent Advising Application
SEG facilitates individualized business advising to help entrepreneurs gain industry expertise, tap into new networks and resources, and build business knowledge and skills.
Para completar este formulario en español,
haga clic aquí.
Individual Questions
First Name:
Last Name:
What are your pronouns?
He, Him, His
She, Her, Hers
They, Them, Theirs
My pronouns are not listed above.
We ask this question as we want to make sure we are addressing everyone in our network correctly.
My pronouns are:
With which gender do you most identify with?
Female
Male
Nonbinary
Prefer not to say
My gender is not listed above.
My gender is:
To which ethnic/racial group(s) do you most identify?
Asian
Black or African American
Hispanic or Latino/a/x
Indigenous Peoples, First Nations, Native American, or Alaska Native
Middle Eastern or North African
Native Hawaiian or other Pacific Islander
White or Caucasian
Prefer not to say
My ethnic/racial group is not listed above.
My ethnic/racial group is:
Your Job Title:
Phone Number:
Phone Number Type:
Home Phone
Mobile
Other Phone
Email:
Email Type:
Personal Email
Work Email
Alternate Email
Mailing Address:
City/Town:
State/Province:
Please select...
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Zip Code:
Venture Questions
Name of Venture:
What does your venture do?
What is your industry? (Select all that apply)
Agriculture
Apparel
Banking
Biotechnology
Chemicals
Communications
Consulting
Construction
Education
Electronics
Energy
Engineering
Entertainment
Environment
Finance
Food and Beverage
Government
Healthcare
Hospitality
Insurance
Machinery
Manufacturing
Media
Not for profit
Recreation
Retail
Shipping
Technology
Telecommunications
Transportation
Utilities
Other
Industry Other:
What is the legal structure of your venture?
Benefit Corporation
C Corp or S Corp
Co-op
Fiscal Sponsorship
For profit
Hybrid
L3C
LLC
Nonprofit
Not yet incorporated
What stage is your venture currently in?
Ideation (no revenue, business or organization is an idea, not yet in operation)
Startup (some revenue, refining business model)
Established (solidified business model, scaling, expanding)
Is there anything else you'd like to add about the current stage of your venture?
Is your organization owned or led by a person who identifies with any of the following qualities?
Age 55 and over
BIPOC (Black, Indigenous, People of Color)
Formerly incarcerated
Has a disability
Immigrant/Refugee
LGBTQIA+
Student
Veteran
Woman
None of the above
Have you completed a Business Model Canvas, Executive Summary, and/or a Value Proposition for your venture? (If you have a current document it will help our volunteer advisors to read this in advance)
Yes
No
Please upload
ONE
of the following: Business Model Canvas, Executive Summary, Value Proposition:
What SEG service are you planning to use?
Resource Office Hours
Independent Advising Program
Please define the questions you'd like answered during Independent Advising sessions:
Have you participated in the SEG Ideator, Incubator and/or Accelerator Program?
Yes
No
Alumni
Have you been in contact with an SEG staff member? If so, please select their name below:
Akisch Lenus
Allie Goyette
Beatrice Mondestil
Constance Ferber
Crollysbet Rodriguez
Emily Ford
Julie Owens
Kristine Pearson
Liz Connell
Margaret Garcia
Matt Ramirez
Naomi Ewen
Natalie Pruell
Ruth Rodriguez
Sarah Whitehouse
Serena Manna
Stefanie Engelhardt
I have not been in touch with an SEG Staff Member
Other
ATTORNEY-CLIENT RELATIONSHIP DISCLAIMER:
The Social Enterprise Greenhouse (SEG) advising program, which includes advising from some of our legal volunteers, is meant to provide general information only and is not intended as a source of formal legal advice. Participation in any session with an attorney volunteer does not create or constitute an attorney-client relationship with any of SEG's attorney volunteers. No general information provided by an SEG legal volunteer to an SEG program participant creates an attorney-client relationship between the volunteer and participant. SEG, its volunteers, program participants and affiliates acknowledge that SEG legal volunteers may not engage in the practice of law on behalf of SEG. I acknowledge that, per this agreement, no advice given or conversations that occur during a volunteer advising session can be constituted as formal legal advice, nor under any agreement or understanding between the volunteers and participants, shall be deemed legal representation.
I have read and I understand this disclaimer.
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