MESO Vancouver Enrollment Form

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Welcome to MESO Vancouver!

We’re excited to learn more about your business / business idea. This form helps us understand your goals, needs, and suitability for MESO’s small business programs and resources.

To be eligible, your business address must be located within the City of Vancouver and your family income must be below 80% of the Washington State Median Family Income (MFI).

Use the Vancouver Washington address search function and the Clark County 2025 income table to verify your eligibility.

The form takes about 15-20 minutes to complete, and you can save your progress and return later if needed.

Questions? Please reach out to meso.wa@mesopdx.org

PERSONAL INFORMATION

First Name

Last Name

Date of birth

Street Address (Mailing)	City
State	Zip Code
County	Country

Preferred Phone	Preferred Email
Mobile Phone	Work Email
House Phone	Personal Email
Work Phone	Alternate Email
Household/Family Size	Annual Household/Family Income
Preferred form of communication	Primary Language

% of Business Ownership (Enter a number without the %)

100 = Sole Ownership; anything else implies you have a business partner(s)

Do you have a business partner(s)?

Yes - interested in being a clientNo or Not interested in being a client

BUSINESS PARTNER CONTACT INFORMATION

First Name

Last Name

Date of birth

Street Address (Mailing)	City
State	Zip Code
County Assignment Region	Country

Preferred Phone	Preferred Email
Mobile Phone	Work Email
House Phone	Personal Email
Work Phone	Alternate Email
Household/Family Size	Annual Household/Family Income
Preferred form of communication	Primary Language
% of Business Ownership (just the numbers 1 - 99)

DEMOGRAPHIC INFORMATION

Gender

LGBTQIA+

Preferred Pronouns

Please Specify

Race

Please Specify

Ethnicity

Native Affiliation (If applicable)

Preferred Language

Are you comfortable communicating with your business advisor in English?

Do you have a disability

Are you a Veteran?

Are you the 'Head of Household'?

Marital Status

Housing Status

Please Specify

Homeless or formerly homeless?

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Pre-Biz / Startup (No Revenue)	Less than 6 months	6 months - 1 year
1 year - 3 years	3 years - 5 years	5+ years

Adelente Mujeres	APANO
Beaverton Chamber of Commerce	Hacienda CDC
Hispanic Metropolitan Chamber (HMC)	IRCO
LatinoBuilt	Lewis and Clark Small Business Legal Clinic
Livelihood NW	Mercy Corps NW
MESO	Metropolitan Family Service
NAMCO	NAYA
Neighborhood House	Nu Leaf Project
ONAC	PBDG
PIE	TiE Oregon
Urban League	XXcelerate

Classes / Workshops	Business Resources
Business Planning	Social Media / Digital Marketing Support
Loans	Credit Building
Business Consulting	Bookkeeping
Other

CI Local character and prosperity	CI Local job creation
CI Environmental impact	CI BIPOC Owned
CI Woman Owned	CI Paying Taxes
CI Local involvement and giving back	CI Increasing NH occupancy
CI Community well-being and vibrancy	CI Veteran Owned

NAICS - Primary	NAICS - Secondary
NAICS - Tertiary