Class Signup

INTAKE & CLASS REGISTRATION FORM

You will only have to fill this out one time, then you can login in the future to register for Technical Assistance, Classes and Events. The programming at the Hilltown CDC is at no cost, but our grant funders require all of the following demographic information. For reporting purposes your name will NOT be associated with your specific demographic information.

Step 1 of 3

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I'm Interested in individual One-on-One Business Assistance

YES

In order to receive FREE one-on-one technical assistance you will need to fill out this form, once this form is completed you will be assigned a business advisor. PLEASE START BY TELLING US WHAT KIND OF ASSISTANCE YOU ARE LOOKING FOR (I.E. Marketing, Finding Grants, Financial Literacy, Startup, General Consulting, Website, IT, Other)

One-on-One Business Assistance - What Kind of Assistance?

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Upcoming Class

Check any upcoming class you want to attend

Username(Required)

Password(Required)

Enter Password Confirm Password

Town of Residence(Required)

Name(Required)

First Last

Email(Required)

Home Address(Required)

Street Address Address Line 2 City State ZIP Code

Cell Phone(Required)

Home Phone

Work Phone

Please Tell Us About Yourself(Required)

Male

Female

Other

Are you an immigrant/non-native English speaker?(Required)

YES

I'd rather not say

Which best describes you(Required)

American Indian or Alaska Native

Asian

Black or African American

Native Hawaiian or Other Pacific Islander

White/Caucasian

Other

Ethnicity(Required)

Hispanic

Non-Hispanic

Are you a Veteran(Required)

YES

Are you part of the LQBTQ+ community(Required)

YES

Which Best Describes Your Age Group?(Required)

Household Size(Required)

Level	Income Ranges for Household Size 1
Extremely Low	$17,700 or under
Very Low	$17,701 to $29,450
Low	$29,451 to $47,150
Over Income	More than $47,150

Level	Income Ranges for Household Size 2
Extremely Low	$20,200 or under
Very Low	$20,201 to $33,650
Low	$33,651 to 53,850
Over Income	More than $53,850

Level	Income Ranges for Household Size 3
Extremely Low	$22,750 or under
Very Low	$22,751 to $37,850
Low	$37,851 to $60,600
Over Income	More than $60,600

Level	Income Ranges for Household Size 4
Extremely Low	$26,500 or under
Very Low	$26,501 to $42,050
Low	$42,051 to $67,300
Over Income	More than $67,300

Level	Income Ranges for Household Size 5
Extremely Low	$31,040 or under
Very Low	$31,041 to $45,450
Low	$45,451 to $72,700
Over Income	More than $72,700

Level	Income Ranges for Household Size 6
Extremely Low	$35,580 or under
Very Low	$35,581 to $48,800
Low	$48,801 to $78,100
Over Income	More than $78,100

Level	Income Ranges for Household Size 7
Extremely Low	$40,120 or under
Very Low	$40,121 to $52,150
Low	$52,151 to $83,500
Over Income	More than $83,500

Level	Income Ranges for Household Size 8
Extremely Low	$44,660 or under
Very Low	$44,661 to $55,550
Low	$55,551 to $88,850
Over Income	More than $88,850

Income Level Based on the Chart Above(Required)

Extremely Low

Very Low

Low

Over Income

Select Your Household Size to Display the Income Range Guidelines