SER Mercado Pop Up Shop

SER Mercado: Pop Up Shop Registration Form

Enrollment ID

Application Status

Contact ID

User

Enrollment Owner

Employment ID

Gender

Which location are you applying for?

First Name

Last Name

Birthdate

Personal Cell Phone

Business Phone number is added in another section.

Personal email address

Please confirm your email address

Email Message

Street Address

City

State

Zip / Postal Code

Work Background

Are you eligible to work in the U.S.?

YesNoEligibility to work in U.S. does not preclude your participation in the program as it does not apply to those launching a business.

Annual Income

Are you currently employed (including self-employment)?

YesNo

Type of employment: Check all that apply.

Regular employmentSelf-employed/Business Owner

Regular Employment

Provide the details for your current employment.

Name of Employer/Organization

Start Date:

Date Hired

Entrepreneurship Interest

Are you interested in starting a small business?

If yes, what industry?

Goal Timeframe

What is your anticipatory goal timeframe?

Business Information

Business name

Business Phone

Business Email

Business Address- Street

Business Address- City

Business Address- State

Business Address- Zip / Postal Code

How long has your business been in operation?

Which of the options below best describes the industry or activities your business conducts? Select all applicable.

Other industry:

How many of your employees are full-time? If none, enter 0.

How many of your employees are part-time? If none, enter 0.

How many of your employees are seasonal/contractual? If none, enter 0.

At the end of 2021, was your business operating at a profit, breaking-even, or operating at a loss?

Operating at a profitBreaking-evenOperating at a lossUnsure/prefer not to answer

How did you hear about SER Entrepreneurship?

SER Mercado Pop-Up Event

Join us for our first-ever SER Mercado Pop-Up Shop on October 22, 2022! We welcome all vendors and participants to join us for this FREE community event that will be located in the SER National back parking lot located in Irving, TX. This event will be from 9:00 am – 2:00 pm. We hope to see you there!

For more information, contact Natalie Cooper at ncooper@ser-national.org or (469) 549-3694.

Event Address:

100 East Royal Lane

Irving, TX 75039

Would you like to register for the SER Mercado event?

YesNo

Are you an attendee or vendor?

AttendeeVendor

If you are registering as a vendor, a business name MUST be provided in the application above. If you will only be attending our event and you do not need a space reserved for you to conduct your business, then please register as an attendee. If no business name is provided, your vendor registration will be classified as an attendee so that we may provide a space for vendors who do have a business and would want a slot.

Are you a food truck vendor?

YesNo

Equipment Acknowledgement

I understand that I am responsible, as a vendor, to provide my own equipment such as a tent, table, chairs, electric generator, marketing materials, and other supplies in order to showcase my business at this event.

Applicant Consent

Consent to Release Media/Photograph

I hereby consent to the use of media containing my likeness as captured during program activities, including photographs, videos, audio recordings and/or other media for the purpose of creating web, mobile, print and social media content to increase awareness, promotion and general public outreach of program activities.

Checking below indicates I have read all the above and agree to its contents.

Applicant agrees

Contact Information

	Yes	No
Do you have an EIN, LLC, DBA?
Do you currently have a business plan?
Do you have a banking account?