Willamette Neighborhood Housing Services

MICROBUSINESS REGISTRATION

Complete the form below and mail your payment to:

Willamette Neighborhood Housing Services
257 SW Madison Ave., Suite 113
Corvallis, OR 97333

We will only use the information below to respond to you in regards to the reason you contacted us. We will not share your information with any third party outside of our organization, other than as necessary to fulfill your request.

**Asterisks denote required information

Name:		**
Address:		**
City, State, ZIP		**
Home Phone:		**
Work Phone:
Cell Phone:
Email:		No email address? Please use info@w-nhs.org.**
Date of workshop:		**
Location:		Albany
		Sweet Home
		Corvallis
		Lebanon
Please give a brief reason why you would like to take part in the MicroEnterprises Program and what you hope to get out of taking this class:

QUESTIONS?

Call Willamette Neighborhood Housing Services at 541.752.7220 or 800.403.0957 or email your questions to class@w-nhs.org.