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First Name
Last Name
Email
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Phone
*
(include country code):
(###)
###
####
LinkedIn Profile or Personal Website:
*
Location (City, Country):
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Your Role / Title
*
Business / Industry Sector:
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Agriculture
Forestry
Fishing
Mining
Oil and Gas Extraction
Food and Beverage Manufacturing
Textile and Apparel Manufacturing
Automotive Manufacturing
Electronics and Electrical Equipment
Chemical Manufacturing
Construction and Building Materials
Aerospace and Defence
Pharmaceuticals
Retail and E-commerce
Wholesale Trade
Transportation and Logistics
Hospitality (Hotels, Resorts, etc.)
Food Services (Restaurants, Catering)
Entertainment and Media
Tourism and Travel Services
Real Estate
Financial Services (Banking, Insurance, Investment)
Healthcare and Medical Services
Legal Services
Accounting and Tax Services
Marketing and Advertising
Education and Training Services
IT and Software Development
Telecommunications
Utilities (Water, Power, Gas)
Research and Development (R&D)
Biotechnology
Consulting Services
Data Analytics and AI
Engineering Services
Environmental Services
Government and Public Administration
Non-profit and NGO Organizations
International Organizations
Think Tanks and Policy Institutes
Years in Operation:
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0 - 2
3 - 5
6 - 10
10 +
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What are your top three business goals for the next 12 months?
Where are you seeking the most support right now?
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Why is now the right time for you to join the Vanguard tier?
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What does legacy mean to you as a woman entrepreneur?
*
*
Have you participated in any of the following Boss Women offerings?
How did you hear about the Vanguard tier?
*
*
What makes you a strong fit for the Vanguard community?
If accepted, are you ready to commit to the full program investment of $20,000 CAD?
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Yes
I’d like to explore payment options
Would you like to be considered for sponsorship or subsidized funding (if available)?
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Yes
No
Date
MM
DD
YYYY
