Certificate in Retail Operations (CROps) Enrollment Application

Date

In the dropdown, choose one *

If Individual Class or Other, please detail

Name *

Address *

City, State, Zip *

Email *

Phone *

Cell *

Emergency Contact *

Relationship *

Phone *

Do you own a business? *

If yes, what is the name of the business and how long have you been in operation?

What is your highest level of education? *

Please be aware there is no requirement that you have a high school diploma or GED to participate in our program. We simply would like to know something about the background of our participants.

Please share with us the type of retail business you currently own or plan to start *

Please share with us the specific gifts, skills, and resources you have that you believe will help you be a successful retailer *

Checkboxes

Tuition for the Certificate in Retail Operations is $495 for the full Certificate and $85 per module. Tuition assistance is available for qualifying individuals. Please check the box to learn about tuition assistance options.
I authorize the Retail Alliance Foundation to release information contained in this form to my local Economic Development offices and funders for the purpose of attaining scholarships and incentives on my behalf.
By checking this box, I give permission for my photo and video recordings to be used for marketing purposes.

Please note:

The Retail Alliance Foundation does not discriminate on the basis of race, color, religion (creed), gender, gender expression, age, national origin (ancestry), disability, marital status, sexual orientation, or military status, in any of its activities or operations.

Signature *

Date *

So we know you are not a computer bot, please complete the Captcha math equation below *

What is 7+4?

Phone