Registration – WiDEN | Connect, Collaborate and Thriving Together!

Please provide a brief description of yourself for the directory:

* Required information. Enter N/A if not applicable.

* Please choose a password and make a note of it so you can access WiDEN account once approved.

* An email notification from WiDEN will be coming from the email address techsupport@mywiden.com.

First Name *

Last Name *

What is the gender of the business owner? *

What is the race of the business owner? *

Contact Phone Number * Enter in a numeric format: XXXXXXXXXX

Email Address *

Password *

Please share some information about your business for the directory as well:

What is the name of your business? *

Please describe your business and services *

Are you affiliated with any of the below chambers? *

What certifications does your business have? *

Select...

Disadvantaged Business Enterprise (DBE) Federal – Small Disadvantaged Businesses SDB/8 (a) Federal – Women-Owned Small business (WOSB) Economically Disadvantaged Woman-Owned Small Business (EDWOSB) Federal – HUBZone Federal – Veteran Owned Small Business (VOSB) – U.S. Department of Veteran’s Affairs Federal – Service Veteran Owned Small Business (SDVOSB) – U.S. Small Business Administration Lesbian, Gay, Bisexual, Transgender Business Enterprise (LGBTBE) NMSDC State of Wisconsin – Woman-Owned Small Business Enterprise (WBE) State of Wisconsin – Disabled Veteran Business (DVB) State of Wisconsin – Minority-Owned Business Enterprise (MBE) WBENC Multiple of the above None of the above Other

Is your business headquartered in Wisconsin? *

What is the business address? *

Is this business a remote or brick and mortar business? *

If this location differs from your business address please list it here. *

Is your business physically located in Wisconsin, even if the HQ isn't? *

Are you a sole-proprietor? *

Do you have an EIN Number? *

Please enter your EIN Number? *

What NAICS sector is your business in? * Please use this link to find out your relevant code if you are unsure: NAICS Code Listing

Would you like to add an additional NAICS Code? * Use comma to separate out each code.

Please provide additional NAICS Code? *

Does your business have SIC codes (Standard Industrial Classification)? If so please provide your primary SIC Code below: * Please use this link to find out your relevant code if you are unsure: SIC Code Listing

What is your business website? *

Please provide your business phone number: * Enter in a numeric format: XXXXXXXXXX

What year was your business established ? *

How many people are currently employed by this business? *

Please use the image below for the next question.

What region is your business located in? *

Select...

1) Visions Northwest 2) Monument West 3) 7 Rivers Alliance 4) Prosperity Southwest 5) Grow North 6) Centergy 7) Madison Region Economic Partnership 8) The New North 9) Milwaukee 7 All Regions/Statewide

Would you like to receive information about free or low-cost technical assistance to help grow your business? (This may include support with business planning, digital marketing, financial management, or technology adoption) *

Please upload a logo for your business here. Logo in PNG file format (500 X 500)

Do you need help growing or scaling your business? *

Can someone from our team contact you to learn more about what your business needs are? *

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Business Registration

Please provide a brief description of yourself for the directory:

Please share some information about your business for the directory as well:

Please use the image below for the next question.