WOSB/EDWOSB Overview – Complimentary Registration

[MM_Form type='checkout' membershipLevelId='1'] [MM_Form_Message type="error"] [MM_Form_Section type='accountInfo']

Thank you for engaging with the U.S. Women's Chamber of Commerce. Please complete the form below to register with the U.S. Women's Chamber of Commerce and attend WOSB/EDWOSB Overview and Certification Process web-conference meeting.

Registration Account Information

*Indicates required field

First Name:*

[MM_Form_Field type='input' name='firstName' customAttributes='placeholder="First Name"']

[MM_Form_Field type='input' name='lastName' customAttributes='placeholder="Last Name"']

[MM_Form_Field type='input' name='username' customAttributes='placeholder="User Name"']

[MM_Form_Field type='input' name='email' customAttributes='placeholder="Email Address"']

[MM_Form_Field type='input' name='password' customAttributes='placeholder="Password"']

[MM_Form_Field type='input' name='phone' isRequired='false' customAttributes='placeholder="Phone Number"']


Business/Organization Details

Business/Organization Name:* [MM_Form_Field type='custom' id='10' isRequired='true' class='']

Title: [MM_Form_Field type='custom' id='7' class='']

Address: [MM_Form_Field type='custom' id='11' class='']

City:* [MM_Form_Field type='custom' id='12' isRequired='true' class='']

State:* [MM_Form_Field type='custom' id='13' isRequired='true' class='']

Zip:* [MM_Form_Field type='custom' id='14' isRequired='true' class='']

Country: [MM_Form_Field type='custom' id='17' class='']

Phone: [MM_Form_Field type='custom' id='15' class='']

Website: [MM_Form_Field type='custom' id='16' class='']

Industry: [MM_Form_Field type='custom' id='18' isRequired='true' class='']

About Me

I am a:* [MM_Form_Field type='custom' id='21' isRequired='true' class='']

My age range is:* [MM_Form_Field type='custom' id='22' isRequired='true' class='']

Race/Ethnicity: [MM_Form_Field type='custom' id='24' class='']

Education:* [MM_Form_Field type='custom' id='89' isRequired='true' class=''] [MM_Form_Field type='custom' id='94' class=''] I am a Veteran

[MM_Form_Field type='custom' id='90' class=''] I am seeking access to government contracts

My Twitter Handle: [MM_Form_Field type='custom' id='93' class='']

How did you hear about the USWCC?: [MM_Form_Field type='custom' id='23' class='']

Select Councils

[MM_Form_Field type='custom' id='38' class=''] Public Policy

[MM_Form_Field type='custom' id='40' class=''] I Vote for Women

[MM_Form_Field type='custom' id='39' class=''] Young Women

[MM_Form_Field type='custom' id='41' class=''] Career & Workplace

[MM_Form_Field type='custom' id='42' class=''] The Women-Led Economy

[MM_Form_Field type='custom' id='43' class=''] Financial Management & Retirement

Select Policy Issues

[MM_Form_Field type='custom' id='76' class=''] Consumer Financial Protection

[MM_Form_Field type='custom' id='77' class=''] Economy

[MM_Form_Field type='custom' id='78' class=''] Energy

[MM_Form_Field type='custom' id='79' class=''] Fair Pay & Workplace Policies

[MM_Form_Field type='custom' id='80' class=''] Appropriations & Budget

[MM_Form_Field type='custom' id='81' class=''] Government Contracting

[MM_Form_Field type='custom' id='82' class=''] Health Care & Benefits

[MM_Form_Field type='custom' id='83' class=''] Commerce & Trade

[MM_Form_Field type='custom' id='84' class=''] Policy & Politics

[MM_Form_Field type='custom' id='85' class=''] Retirement

[MM_Form_Field type='custom' id='86' class=''] Small Business

[MM_Form_Field type='custom' id='87' class=''] Technology & Communications

[MM_Form_Field type='custom' id='88' class=''] Veterans & Women in the Military

My Address

[MM_Form_Field name='billingAddress' customAttributes='placeholder="Billing Address"']

[MM_Form_Field name='billingCity' customAttributes='placeholder="Billing City"']

[MM_Form_Field name='billingState' customAttributes='placeholder="Billing State"']

[MM_Form_Field name='billingZipCode' customAttributes='placeholder="Billing Zip Code"']

[MM_Form_Field name='billingCountry']

I accept the USWCC terms and conditions.