First Name*
 
 
Last Name*
 
 
Telephone Number*
 
 
Email*
 
 
 
Gender *
 
Male
 
 
Female
 
 
Prefer not to say
 
 
 
Are you an applicant of the Provincial Nominee Program (PNP)?*
 
Yes
No
 
 
If yes, select your country of origin:
 
 
 
In which stage of business are you? * 
 
Pre-Business (thinking of starting)
 
 
New Business (less than 2 years)
 
 
Existing Business (2 years or more)
 
 
 
Description of company’s activities (i.e. “what do you do"):*
 
 
 
Description of products and services:*
 
 
 
Please check all information that is pertinent to you:
 
Woman Entrepreneur
 
 
Youth Entrepreneur (18-29)
 
 
Youth Entrepreneur (30-40)
 
 
Indigenous Entrepreneur
 
 
Newcomer
 
 
Entrepreneur with Health Condition or Disability
 
 
Francophone
 
 
 
Please check all information that is pertinent to your business:
 
Rural Business (operating outside of Winnipeg)
 
 
Home-Based Business (operating within your home)
 
 
Import
 
 
Export
 
 
Looking for Financing
 
 
Permit/Licencing
 
 
Taxation
 
 
Hiring Employees
 
 
 
Other information: