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Hilltown CDC

387 Main Road Chesterfield MA 01012

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Page 1

Which Classes Would You Like to Register For^*

Business Tax Basics: What to keep and why Thursday, October 7th 6-7:30pm
Business payroll: Employee vs Subcontractor- rules and responsibilities Thursday, October 28th 6-7:30pm
Make the most of your Online Hilltown Business Directory listing - Monday, September 20th 6-7:30pm
Make the most of your Online Hilltown Business Directory listing. Tuesday, October 5th 12:30 – 2pm
Make the most of your Online Hilltown Business Directory listing - Tuesday, November 9th 8am – 9:30am
Make the most of your Online Hilltown Business Directory listing - Tuesday, November 9th 5-6:30PM
Intro To QuickBooks Wednesday, Sept 22nd & 29th 6-7:70pm
QuickBooks: Beyond Basics Wednesday, October 13th & 20th, 6-7:30pm
Business Accounting and Taxes w/ QuickBooks, Wednesday Nov 10th & 17th 6-7:30pm
Email Newsletters: Staying in Contact with your clients Thursday, October 14th 6-7:30pm
Content planning for a new year w/ Robyn Miller Wednesday, December 1, 6-7:30pm

Town of Residence^*

First Name

Last Name

Email^*

Username^*

Password^*

Password must be at least 7 characters long.

Enter password again^*

Password must be at least 7 characters long.

Home Address

Address Line 1 ^*

Address Line 2

City ^*

State or Region ^*

Country

Zip ^*

Cell Phone^*

Home Phone

Work Phone

Please Tell Us About Yourself^*

Male
Female
Other

Are you an immigrant/non-native English speaker?^*

YES
NO
I'd rather not say

Which best describes you?^*

American Indian or Alaska Native
Asian
Black or African American
Native Hawaiian or Other Pacific Islander
White/Caucasian
Other

Ethnicity^*

Hispanic
Non-Hispanic

Are you a Veteran?^*

YES
NO

Are you part of the LGBTQ+ community?

YES
NO

Which Best Describes Your Age Group?^*

Under 25
25 to 35
35 to 45
45 to 59
60 years or older

Are you disabled?^*

YES
NO

What is your current work status^*

Self Employed
Employed
Student
Retired
Unemployed
Other

Are you the the head of a single parent household?^*

YES
NO

Household Size^*

Please choose the income that best fits your household of 1

Below $18,650
$18,651 to $31,050
$31,051 to $49,700
$49,701 +

Please choose the income that best fits your household of 2

Below $21,300
$21,301to $35,500
$35,501 to $56,800
$56,801 +

Please choose the income that best fits your household of 3

Below $23,950
$23,951 to $39,950
$39,951to $63,900
$63,901 +

Please choose the income that best fits your household of 4

Below $26,600
$26,601 to $44,350
$44,351 to $70,950
$70,951 +

Please choose the income that best fits your household of 5

Below $30,170
$30,171 to $47,900
$47,901 to $76,650
$76,651 +

Please choose the income that best fits your household of 6

Below $34,590
$34,591 to $51,450
$51,451 to $82,350
$82,351 +

Please choose the income that best fits your household of 7

Below $39,010
$39,011 to $55,000
$55,001 to $88,000
$88,001 +

Please choose the income that best fits your household of 8

Below $43,430
$43,431 to $58,550
$58,551 to $93,700
$93,701 +

Page 2

Tell Us A Little About Your Business

Business Name^*

Business Address

Address Line 1 ^*

Address Line 2

City ^*

State or Region ^*

Country

Zip ^*

Website

https://

Total Number of Employees (including owners)^*

Number of Full Time Employees

Number of Part Time Employees

What best describes your business status now?^*

Is this business Woman Owned?^*

YES
NO

Is the business any of the following?^*

African American Owned Business
LatinX Owned Business
Asian Owned Business
Native American Owned Business
LGBTQ Owned Business
None of the Above
Other

Is this business Veteran Owned?^*

YES
NO

Is this business a Cooperative^*

YES
NO

Page 3

Tell us how the Hilltown CDC can help you?

What assistance are you seeking

Exploring a business idea
Creating a business plan
Starting a business
Expanding your business
Marketing/advertising your business
Purchasing a business
Value-added Farm Product
Financial management/planning
IT/Web Support
Accouting assistance
Rental Space
Seeking a loan
Food processing center/Food business
Other

What best describes your current employment status?

How did you hear about Hilltown CDC's Small Business Development Program?

Comments or Questions

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