Child Care Business Planning Software

I request business management counseling and/or training from The Wisconsin Women's Business Initiative Corporation (WWBIC) which is funded partly by the US Small Business Administration. I agree to cooperate should I be selected to participate in surveys designed to evaluate 58A funded services. I understand that any information received by WWBIC will be held in confidence to the extent permitted 6y law. I further understand that the counselor or trainer in this program has agreed 1) not to recommend goods or services in which he/she has an interest and 2) not to accept fees or commissions developing from this counseling relationship In consideration of SBA's funding of WWBIC and the assistance to be furnished, I agree to waive all claims arising cut of this assistance against SBA personnel, WWBIC, its host organization, and the resource counselors) who assisted me. I formally authorize WWBIC to use my name and image for promotional activities sponsored by WWBIC.

I certify that all my statements on this form are correct to the best of my knowledge and that I will cooperate in providing follow up information needed to evaluate the effectiveness of the program if asked by an authorized representative of WWBIC.