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contact.ventureniagara.com Open in urlscan Pro
52.237.18.220  Public Scan

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URL: https://contact.ventureniagara.com/
Submission: On November 07 via automatic, source certstream-suspicious — Scanned from CA

Form analysis 3 forms found in the DOM

<form id="form-step-1" class="ui form" data-bind="with: $root.Step1">
  <div class="ui message">
    <p><strong>Note: <u>Do not hit</u> the refresh button<i class="redo icon"></i> as all entered information will be deleted!</strong></p>
  </div>
  <h3 class="ui dividing header">Personal information</h3>
  <div class="two fields">
    <div class="three wide field">
      <label>Title</label>
      <select class="ui dropdown" name="step1-title" id="select-title" data-bind="options: $root.TitleOptions,
                                       optionsText: 'Value',
                                       optionsValue: 'Id',
                                       value: TitleId,
                                       childrenComplete: $root.titleNameSelected,
                                       event: { change: $root.titleNameChanged}">
        <option value="0">Mr</option>
        <option value="1">Ms</option>
        <option value="2">Mrs</option>
        <option value="3">Mx</option>
        <option value="4">Dr</option>
        <option value="5">Prof</option>
        <option value="6">Rev</option>
      </select>
    </div>
  </div>
  <div class="three fields">
    <div class="four wide required field">
      <label>First name</label>
      <input type="text" name="fname" autocomplete="given-name" data-bind="textInput: FirstName">
    </div>
    <div class="five wide required field">
      <label>Last name</label>
      <input type="text" name="lname" autocomplete="family-name" data-bind="textInput: LastName">
    </div>
    <div class="four wide field">
      <label>Middle name</label>
      <input type="text" name="mname" placeholder="Optional" autocomplete="additional-name" data-bind="textInput: MiddleName">
    </div>
  </div>
  <div class="fields">
    <div class="four wide field">
      <label>Gender</label>
      <div class="ui dropdown selection" tabindex="0"><select name="step1-gender" id="step1-gender" data-bind="options: $root.GenderOptions,
                                       optionsText: 'Value',
                                       optionsValue: 'Id',
                                       value: GenderId,
                                       childrenComplete: $root.genderNameSelected,
                                       event: { change: $root.genderNameChanged}" class="">
          <option value="0">Male</option>
          <option value="1">Female</option>
          <option value="2">Other</option>
          <option value="3">Prefer not to answer</option>
        </select><i class="dropdown icon"></i>
        <div class="text">Male</div>
        <div class="menu" tabindex="-1">
          <div class="item active selected" data-value="0" data-text="Male">Male</div>
          <div class="item" data-value="1" data-text="Female">Female</div>
          <div class="item" data-value="2" data-text="Other">Other</div>
          <div class="item" data-value="3" data-text="Prefer not to answer">Prefer not to answer</div>
        </div>
      </div>
    </div>
    <div class="four wide required field">
      <label>Phone</label>
      <input type="tel" name="step1-phone" id="step1-phone" data-bind="textInput: PhoneNumber">
    </div>
    <div class="four wide required field">
      <label>Email</label>
      <input type="email" name="step1-email" data-bind="textInput: Email">
    </div>
  </div>
  <h3 class="ui dividing header">Home address</h3>
  <div class="six wide field">
    <label>Address Search</label>
    <div id="home-address-search" class="ui fluid search">
      <div class="ui icon input">
        <input class="prompt" type="text" placeholder="Search for address..." autocomplete="off">
        <i class="search icon"></i>
      </div>
      <div class="results"></div>
    </div>
  </div>
  <div class="sixteen wide field">
    <label>Address 1</label>
    <div class="two fields">
      <div class="twelve wide field">
        <input type="text" name="step1-line1" autocomplete="off" data-bind="textInput: Address1">
      </div>
      <div class="four wide field">
        <input type="text" name="step1-line2" autocomplete="off" data-bind="textInput: Address2">
      </div>
    </div>
  </div>
  <div class="three fields">
    <div class="six wide required field">
      <label>City</label>
      <input type="text" name="step1-city" autocomplete="off" data-bind="textInput: City">
    </div>
    <div class="six wide required field">
      <label>Province</label>
      <div class="ui dropdown selection" tabindex="0"><select name="step1-province" id="step1-province" data-bind="options: $root.ProvinceOptions,
                                       optionsText: 'Value',
                                       optionsValue: 'Id',
                                       value: ProvinceId,
                                       childrenComplete: $root.provinceNameSelected,
                                       event: { change: $root.provinceNameChanged}" class="">
          <option value="0">Ontario</option>
          <option value="1">Alberta</option>
          <option value="2">British Columbia</option>
          <option value="3">Manitoba</option>
          <option value="4">Newfoundland and Labrador</option>
          <option value="5">New Brunswick</option>
          <option value="6">Nova Scotia</option>
          <option value="7">Prince Edward Island</option>
          <option value="8">Saskatchewan</option>
          <option value="9">Quebec</option>
          <option value="10">Northwest Territories</option>
          <option value="11">Yukon</option>
          <option value="12">Nunavut</option>
          <option value="13">Other</option>
        </select><i class="dropdown icon"></i>
        <div class="text">Ontario</div>
        <div class="menu" tabindex="-1">
          <div class="item active selected" data-value="0" data-text="Ontario">Ontario</div>
          <div class="item" data-value="1" data-text="Alberta">Alberta</div>
          <div class="item" data-value="2" data-text="British Columbia">British Columbia</div>
          <div class="item" data-value="3" data-text="Manitoba">Manitoba</div>
          <div class="item" data-value="4" data-text="Newfoundland and Labrador">Newfoundland and Labrador</div>
          <div class="item" data-value="5" data-text="New Brunswick">New Brunswick</div>
          <div class="item" data-value="6" data-text="Nova Scotia">Nova Scotia</div>
          <div class="item" data-value="7" data-text="Prince Edward Island">Prince Edward Island</div>
          <div class="item" data-value="8" data-text="Saskatchewan">Saskatchewan</div>
          <div class="item" data-value="9" data-text="Quebec">Quebec</div>
          <div class="item" data-value="10" data-text="Northwest Territories">Northwest Territories</div>
          <div class="item" data-value="11" data-text="Yukon">Yukon</div>
          <div class="item" data-value="12" data-text="Nunavut">Nunavut</div>
          <div class="item" data-value="13" data-text="Other">Other</div>
        </div>
      </div>
    </div>
    <div class="three wide field">
      <label>Postal code</label>
      <input type="text" name="step1-postalcode" maxlength="7" placeholder="A1B 2C3" autocomplete="off" data-bind="textInput: PostalCode">
    </div>
  </div>
  <div class="two fields">
    <div class="six wide field">
      <label>Municipality</label>
      <div class="ui dropdown selection" tabindex="0"><select name="step1-municipality" id="step1-municipality" data-bind="options: $root.MunicipalityOptions,
                                       optionsText: 'Value',
                                       optionsValue: 'Id',
                                       optionsCaption: '',
                                       value: MunicipalityId,
                                       event: { change: $root.personMunicipalityNameChanged}" class="noselection">
          <option value=""></option>
          <option value="12">Fort Erie</option>
          <option value="8">Grimsby</option>
          <option value="9">Lincoln</option>
          <option value="13">Niagara Falls</option>
          <option value="10">Niagara-on-the-Lake</option>
          <option value="3">Other</option>
          <option value="5">Pelham</option>
          <option value="14">Port Colborne</option>
          <option value="11">St. Catharines</option>
          <option value="7">Thorold</option>
          <option value="6">Wainfleet</option>
          <option value="4">Welland</option>
        </select><i class="dropdown icon"></i>
        <div class="text"></div>
        <div class="menu" tabindex="-1">
          <div class="item" data-value="12" data-text="Fort Erie">Fort Erie</div>
          <div class="item" data-value="8" data-text="Grimsby">Grimsby</div>
          <div class="item" data-value="9" data-text="Lincoln">Lincoln</div>
          <div class="item" data-value="13" data-text="Niagara Falls">Niagara Falls</div>
          <div class="item" data-value="10" data-text="Niagara-on-the-Lake">Niagara-on-the-Lake</div>
          <div class="item" data-value="3" data-text="Other">Other</div>
          <div class="item" data-value="5" data-text="Pelham">Pelham</div>
          <div class="item" data-value="14" data-text="Port Colborne">Port Colborne</div>
          <div class="item" data-value="11" data-text="St. Catharines">St. Catharines</div>
          <div class="item" data-value="7" data-text="Thorold">Thorold</div>
          <div class="item" data-value="6" data-text="Wainfleet">Wainfleet</div>
          <div class="item" data-value="4" data-text="Welland">Welland</div>
        </div>
      </div>
    </div>
  </div>
  <h3 class="ui dividing header">Additional information</h3>
  <div class="two fields">
    <div class="five wide field">
      <label>How should we get in contact with you? (select all that apply)</label>
      <div class="ui dropdown selection multiple" tabindex="0"><select multiple="" name="step1-contactmethod" id="step1-contactmethod" data-bind="event: { change: $root.contactMethodChanged }" class="noselection">
          <option id="email">Email</option>
          <option id="phone">Phone</option>
        </select><i class="dropdown icon"></i>
        <div class="text"></div>
        <div class="menu" tabindex="-1">
          <div class="item" data-value="Email" data-text="Email">Email</div>
          <div class="item" data-value="Phone" data-text="Phone">Phone</div>
        </div>
      </div>
    </div>
    <div class="field">
      <label>Subscribe to our newsletter?</label>
      <div class="ui checkbox">
        <input type="checkbox" name="example" data-bind="event: { change: $root.subscribeNewsletterClicked }" tabindex="0" class="hidden">
        <label>Yes, I want to subscribe</label>
      </div>
    </div>
  </div>
  <div class="eight wide field">
    <label>Self-identifying inclusiveness (select all that apply)</label>
    <div class="ui fluid dropdown f-multiple selection multiple" tabindex="0"><select id="select-targetgroups" name="step1-targetgrouplists" data-bind="options: $root.TargetGroupListOptions,
                                   optionsText: 'Value',
                                   optionsValue: 'Id',
                                   optionsCaption: ''
                            " multiple="multiple" class="noselection">
        <option value=""></option>
        <option value="11">EI - Recipient</option>
        <option value="14">General Populace</option>
        <option value="1">Indigenous Peoples</option>
        <option value="23">LGBTQ2+</option>
        <option value="24">New Canadian</option>
        <option value="2">Official Language Minority Community</option>
        <option value="5">Other</option>
        <option value="6">Persons with Disabilities</option>
        <option value="17">Prefer not to answer</option>
        <option value="22">Seniors</option>
        <option value="7">Social Economy Enterprises</option>
        <option value="16">Student</option>
        <option value="8">Visible Minority</option>
        <option value="3">Women</option>
        <option value="4">Youth</option>
      </select><i class="dropdown icon"></i>
      <div class="text"></div>
      <div class="menu" tabindex="-1">
        <div class="item" data-value="11" data-text="EI - Recipient">EI - Recipient</div>
        <div class="item" data-value="14" data-text="General Populace">General Populace</div>
        <div class="item" data-value="1" data-text="Indigenous Peoples">Indigenous Peoples</div>
        <div class="item" data-value="23" data-text="LGBTQ2+">LGBTQ2+</div>
        <div class="item" data-value="24" data-text="New Canadian">New Canadian</div>
        <div class="item" data-value="2" data-text="Official Language Minority Community">Official Language Minority Community</div>
        <div class="item" data-value="5" data-text="Other">Other</div>
        <div class="item" data-value="6" data-text="Persons with Disabilities">Persons with Disabilities</div>
        <div class="item" data-value="17" data-text="Prefer not to answer">Prefer not to answer</div>
        <div class="item" data-value="22" data-text="Seniors">Seniors</div>
        <div class="item" data-value="7" data-text="Social Economy Enterprises">Social Economy Enterprises</div>
        <div class="item" data-value="16" data-text="Student">Student</div>
        <div class="item" data-value="8" data-text="Visible Minority">Visible Minority</div>
        <div class="item" data-value="3" data-text="Women">Women</div>
        <div class="item" data-value="4" data-text="Youth">Youth</div>
      </div>
    </div>
  </div>
  <div class="grouped required fields">
    <label>Are you the owner of a business?</label>
    <div class="field">
      <div class="ui radio checkbox checked" data-bind="click: $root.isBusinessOwner.bind($data, true)">
        <input type="radio" name="step1-owner" checked="checked" tabindex="0" class="hidden">
        <label>Yes</label>
      </div>
    </div>
    <div class="field">
      <div class="ui radio checkbox" data-bind="click: $root.isBusinessOwner.bind($data, false)">
        <input type="radio" name="step1-owner" tabindex="0" class="hidden">
        <label>No</label>
      </div>
    </div>
  </div>
  <div class="fields" data-bind="visible: $root.IsBusinessOwner">
    <div class="three wide field">
      <label>Ownership %</label>
      <div class="ui right labeled input">
        <input type="number" name="step1-ownership" min="0" max="100" step="5" data-bind="textInput: OwnershipPercentage">
        <div class="ui basic label"> % </div>
      </div>
    </div>
  </div>
  <div class="ui error message"></div>
</form>

<form id="form-step-2" class="ui form" data-bind="with: $root.Step2">
  <div class="ui message">
    <p><strong>Note: <u>Do not hit</u> the refresh button<i class="redo icon"></i> as all entered information will be deleted!</strong></p>
  </div>
  <h3 class="ui dividing header">Your business</h3>
  <div class="fields">
    <div class="five wide required field">
      <label>Business name (use personal name if unknown)</label>
      <input type="text" name="step2-business-name" data-bind="textInput: BusinessName">
    </div>
    <div class="five wide required field">
      <label>Business stage</label>
      <div class="ui dropdown selection" tabindex="0"><select name="step2-business-stage" id="step2-business-stage" data-bind="options: $root.BusinessStageOptions,
                                           value: BusinessStage" class="">
          <option value="Start-up">Start-up</option>
          <option value="Maintenance">Maintenance</option>
          <option value="Expansion">Expansion</option>
          <option value="Purchase of existing business">Purchase of existing business</option>
          <option value="Sale of existing business">Sale of existing business</option>
          <option value="Other">Other</option>
        </select><i class="dropdown icon"></i>
        <div class="text">Start-up</div>
        <div class="menu" tabindex="-1">
          <div class="item active selected" data-value="Start-up" data-text="Start-up">Start-up</div>
          <div class="item" data-value="Maintenance" data-text="Maintenance">Maintenance</div>
          <div class="item" data-value="Expansion" data-text="Expansion">Expansion</div>
          <div class="item" data-value="Purchase of existing business" data-text="Purchase of existing business">Purchase of existing business</div>
          <div class="item" data-value="Sale of existing business" data-text="Sale of existing business">Sale of existing business</div>
          <div class="item" data-value="Other" data-text="Other">Other</div>
        </div>
      </div>
    </div>
    <div class="four wide field">
      <label>Start date</label>
      <div class="ui calendar" id="div-start-date">
        <div class="ui input left icon">
          <div class="ui popup calendar">
            <table class="ui celled center aligned unstackable table year">
              <thead>
                <tr>
                  <th colspan="3"><span class="link">2021 - 2032</span><span class="prev link"><i class="chevron left icon"></i></span><span class="next link disabled"><i class="chevron right icon"></i></span></th>
                </tr>
              </thead>
              <tbody>
                <tr>
                  <td class="link">2021</td>
                  <td class="link">2022</td>
                  <td class="link">2023</td>
                </tr>
                <tr>
                  <td class="link today focus">2024</td>
                  <td class="link disabled">2025</td>
                  <td class="link disabled">2026</td>
                </tr>
                <tr>
                  <td class="link disabled">2027</td>
                  <td class="link disabled">2028</td>
                  <td class="link disabled">2029</td>
                </tr>
                <tr>
                  <td class="link disabled">2030</td>
                  <td class="link disabled">2031</td>
                  <td class="link disabled">2032</td>
                </tr>
              </tbody>
            </table>
          </div>
          <i class="calendar icon"></i>
          <input type="text" name="step2-start-date" readonly="">
        </div>
      </div>
    </div>
  </div>
  <div class="two fields">
    <div class="five wide field">
      <label>Legal name</label>
      <input type="text" name="step2-legal-name" placeholder="Optional" data-bind="textInput: LegalName">
    </div>
    <div class="five wide required field">
      <label>Legal type</label>
      <div class="ui dropdown selection" tabindex="0"><select name="step2-legal-type" id="step2-legal-type" data-bind="options: $root.LegalTypeOptionsFiltered,
                                       optionsText: 'Value',
                                       optionsValue: 'Id',
                                       optionsCaption: '',
                                       value: LegalTypeId,
                                       event: { change: $root.legalTypeNameChanged}" class="noselection">
          <option value=""></option>
          <option value="2">Incorporated</option>
          <option value="5">Not for Profit</option>
          <option value="4">Partnership</option>
          <option value="7">Project Partner</option>
          <option value="3">Sole Proprietorship</option>
        </select><i class="dropdown icon"></i>
        <div class="text"></div>
        <div class="menu" tabindex="-1">
          <div class="item" data-value="2" data-text="Incorporated">Incorporated</div>
          <div class="item" data-value="5" data-text="Not for Profit">Not for Profit</div>
          <div class="item" data-value="4" data-text="Partnership">Partnership</div>
          <div class="item" data-value="7" data-text="Project Partner">Project Partner</div>
          <div class="item" data-value="3" data-text="Sole Proprietorship">Sole Proprietorship</div>
        </div>
      </div>
    </div>
  </div>
  <div class="nine wide required field">
    <label>What is your primary business sector? (Type 'other' if not sure)</label>
    <input type="text" name="step2-naics" placeholder="Industry..." data-bind="textInput: OtherIndustry">
  </div>
  <h3 class="ui dividing header">Business contact information</h3>
  <div class="field">
    <div class="ui checkbox" data-bind="event: { click: $root.businessContactInfoChanged }">
      <input type="checkbox" tabindex="0" class="hidden">
      <label><strong>Tick if Business contact information is the same as personal contact information</strong></label>
    </div>
  </div>
  <div class="fields" data-bind="hidden: $root.BusinessContactInfoRequired">
    <div class="four wide required field">
      <label>Phone</label>
      <input type="tel" name="step2-phone" id="step2-phone" data-bind="textInput: BusinessPhone">
    </div>
    <div class="five  wide required field">
      <label>Email</label>
      <input type="email" name="step2-email" id="step2-email" data-bind="textInput: BusinessEmail">
    </div>
  </div>
  <h3 class="ui dividing header">Business address</h3>
  <div class="eight wide field">
    <div class="ui checkbox" data-bind="event: { click: $root.businessAddressChanged }">
      <input type="checkbox" tabindex="0" class="hidden">
      <label><strong>Tick if Business address is the same as personal address</strong></label>
    </div>
  </div>
  <div data-bind="hidden: $root.BusinessAddressRequired">
    <div class="six wide field">
      <div id="business-address-search" class="ui fluid search">
        <div class="ui icon input">
          <input class="prompt" type="text" placeholder="Search for address..." autocomplete="off">
          <i class="search icon"></i>
        </div>
        <div class="results"></div>
      </div>
    </div>
    <div class="sixteen wide field">
      <label>Address 1</label>
      <div class="two fields">
        <div class="twelve wide field">
          <input type="text" name="step2-line1" id="step2-line1" autocomplete="off" data-bind="textInput: Address1">
        </div>
        <div class="four wide field">
          <input type="text" name="step2-line2" id="step2-line2" placeholder="Optional" autocomplete="off" data-bind="textInput: Address2">
        </div>
      </div>
    </div>
    <div class="three fields">
      <div class="six wide required field">
        <label>City</label>
        <input type="text" name="step2-city" id="step2-city" autocomplete="off" data-bind="textInput: City">
      </div>
      <div class="six wide required field">
        <label>Province</label>
        <div class="ui dropdown selection" tabindex="0"><select name="step2-province" id="step2-province" data-bind="options: $root.ProvinceOptions,
                                       optionsText: 'Value',
                                       optionsValue: 'Id',
                                       value: ProvinceId,
                                       childrenComplete: $root.businessProvinceNameSelected,
                                       event: { change: $root.businessProvinceNameChanged}" class="">
            <option value="0">Ontario</option>
            <option value="1">Alberta</option>
            <option value="2">British Columbia</option>
            <option value="3">Manitoba</option>
            <option value="4">Newfoundland and Labrador</option>
            <option value="5">New Brunswick</option>
            <option value="6">Nova Scotia</option>
            <option value="7">Prince Edward Island</option>
            <option value="8">Saskatchewan</option>
            <option value="9">Quebec</option>
            <option value="10">Northwest Territories</option>
            <option value="11">Yukon</option>
            <option value="12">Nunavut</option>
            <option value="13">Other</option>
          </select><i class="dropdown icon"></i>
          <div class="text">Ontario</div>
          <div class="menu" tabindex="-1">
            <div class="item active selected" data-value="0" data-text="Ontario">Ontario</div>
            <div class="item" data-value="1" data-text="Alberta">Alberta</div>
            <div class="item" data-value="2" data-text="British Columbia">British Columbia</div>
            <div class="item" data-value="3" data-text="Manitoba">Manitoba</div>
            <div class="item" data-value="4" data-text="Newfoundland and Labrador">Newfoundland and Labrador</div>
            <div class="item" data-value="5" data-text="New Brunswick">New Brunswick</div>
            <div class="item" data-value="6" data-text="Nova Scotia">Nova Scotia</div>
            <div class="item" data-value="7" data-text="Prince Edward Island">Prince Edward Island</div>
            <div class="item" data-value="8" data-text="Saskatchewan">Saskatchewan</div>
            <div class="item" data-value="9" data-text="Quebec">Quebec</div>
            <div class="item" data-value="10" data-text="Northwest Territories">Northwest Territories</div>
            <div class="item" data-value="11" data-text="Yukon">Yukon</div>
            <div class="item" data-value="12" data-text="Nunavut">Nunavut</div>
            <div class="item" data-value="13" data-text="Other">Other</div>
          </div>
        </div>
      </div>
      <div class="three wide field">
        <label>Postal code</label>
        <input type="text" name="step2-postalcode" id="step2-postalcode" maxlength="7" placeholder="A1B 2C3" autocomplete="off" data-bind="textInput: PostalCode">
      </div>
    </div>
    <div class="two fields">
      <div class="six wide field">
        <label>Municipality</label>
        <div class="ui dropdown selection" tabindex="0"><select name="step2-municipality" id="step2-municipality" data-bind="options: $root.MunicipalityOptions,
                                       optionsText: 'Value',
                                       optionsValue: 'Id',
                                       optionsCaption: '',
                                       value: MunicipalityId,
                                       event: { change: $root.municipalityNameChanged}" class="noselection">
            <option value=""></option>
            <option value="12">Fort Erie</option>
            <option value="8">Grimsby</option>
            <option value="9">Lincoln</option>
            <option value="13">Niagara Falls</option>
            <option value="10">Niagara-on-the-Lake</option>
            <option value="3">Other</option>
            <option value="5">Pelham</option>
            <option value="14">Port Colborne</option>
            <option value="11">St. Catharines</option>
            <option value="7">Thorold</option>
            <option value="6">Wainfleet</option>
            <option value="4">Welland</option>
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          <div class="text"></div>
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            <div class="item" data-value="12" data-text="Fort Erie">Fort Erie</div>
            <div class="item" data-value="8" data-text="Grimsby">Grimsby</div>
            <div class="item" data-value="9" data-text="Lincoln">Lincoln</div>
            <div class="item" data-value="13" data-text="Niagara Falls">Niagara Falls</div>
            <div class="item" data-value="10" data-text="Niagara-on-the-Lake">Niagara-on-the-Lake</div>
            <div class="item" data-value="3" data-text="Other">Other</div>
            <div class="item" data-value="5" data-text="Pelham">Pelham</div>
            <div class="item" data-value="14" data-text="Port Colborne">Port Colborne</div>
            <div class="item" data-value="11" data-text="St. Catharines">St. Catharines</div>
            <div class="item" data-value="7" data-text="Thorold">Thorold</div>
            <div class="item" data-value="6" data-text="Wainfleet">Wainfleet</div>
            <div class="item" data-value="4" data-text="Welland">Welland</div>
          </div>
        </div>
      </div>
    </div>
  </div>
  <div class="ui error message"></div>
</form>

<form id="form-step-3" class="ui form" data-bind="with: $root.Step3">
  <div class="ui message">
    <p><strong>Note: <u>Do not hit</u> the refresh button<i class="redo icon"></i> as all entered information will be deleted!</strong></p>
  </div>
  <h3 class="ui dividing header">How can we help you?</h3>
  <div class="two fields">
    <div class="field">
      <label>What Service are you looking for?" "(select all that apply)</label>
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        <input type="number" name="step3-application-amount" min="0" step="500" data-bind="textInput: ApplicationAmount">
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  <div class="two fields">
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        <input type="checkbox" name="on-reserve" tabindex="0" class="hidden">
        <label>Yes</label>
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          <option value="Operating line">Operating line</option>
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          <div class="item" data-value="Term loan" data-text="Term loan">Term loan</div>
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          <div class="item" data-value="Equity" data-text="Equity">Equity</div>
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    <div class="field">
      <label>How will you be using the funding? (select all that apply)</label>
      <div class="ui fluid dropdown f-multiple selection multiple" tabindex="0"><select id="select-funding-uses" name="step3-funding-uses" data-bind="options: $root.FundingUsageOptions" multiple="" class="noselection">
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          <option value="Equipment">Equipment</option>
          <option value="Leasehold/Renovations">Leasehold/Renovations</option>
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  <div class="sixteen wide field">
    <label>How many employees do you plan to hire this year?</label>
    <div class="three fields">
      <div class="three wide field">
        <input type="number" name="step3-planned-ft-employees" autocomplete="off" min="0" placeholder="Full time" data-bind="textInput: NumberOfPlannedFTHires">
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      <div class="three wide field">
        <input type="number" name="step3-planned-pt-employees" autocomplete="off" min="0" placeholder="Part time" data-bind="textInput: NumberOfPlannedPTHires">
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  </div>
  <div class="five wide required field">
    <label>How did you hear about us?</label>
    <div class="ui dropdown selection" tabindex="0"><select id="hear-about-us" name="step3-hear-about-us" data-bind="event: { change:$root.referralSourceNameChanged },
                                       options: $root.ReferralSourceOptions,
                                       optionsText: 'Value',
                                       optionsCaption: '',
                                       optionsValue: 'Id',
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        <option value=""></option>
        <option value="60">Accel North</option>
        <option value="26">AdMail Campaign</option>
        <option value="48">Bank or Credit Union</option>
        <option value="3">Brochure(s)</option>
        <option value="43">Brock University</option>
        <option value="4">Business Development Bank (BDC)</option>
        <option value="7">Canada.ca - Service Canada Centre</option>
        <option value="49">Canadian Small Business Financing Program (CSBFP)</option>
        <option value="5">CFDC - Community Futures Development Corporation</option>
        <option value="8">Chamber of Commerce</option>
        <option value="9">Current/Past Client</option>
        <option value="32">Current/Past Prospect</option>
        <option value="6">Employment Help Centre</option>
        <option value="34">Export Development Canada (EDC)</option>
        <option value="58">Fair Finance Fund (FFF)</option>
        <option value="37">Farm Credit Canada (FCC)</option>
        <option value="35">FedDev Ontario SBS</option>
        <option value="45">FedDev RRRF</option>
        <option value="46">Futurpreneur</option>
        <option value="10">Human Resources Development Canada</option>
        <option value="44">Innovate Niagara</option>
        <option value="12">Municipality &amp; EDO</option>
        <option value="23">Newspaper Ad</option>
        <option value="33">Niagara Angel Network</option>
        <option value="42">Niagara College</option>
        <option value="40">Niagara Community Foundation (NCF)</option>
        <option value="31">Niagara Falls Innovation Hub (Spark Niagara)</option>
        <option value="29">Niagara Falls Small Business Enterprise Centre (NFSBEC)</option>
        <option value="41">Niagara Folk Arts Multicultural Centre</option>
        <option value="38">Niagara Region - EDO</option>
        <option value="47">NRC - IRAP</option>
        <option value="36">OMAFRA</option>
        <option value="57">Other</option>
        <option value="59">PARO</option>
        <option value="14">Radio Announcement</option>
        <option value="39">SOFII</option>
        <option value="50">SR&amp;ED Program</option>
        <option value="30">St. Catharines Enterprise Centre (SCEC)</option>
        <option value="51">Venture Niagara - CED</option>
        <option value="27">Venture Niagara - Loans</option>
        <option value="25">Web Search and Social Media</option>
        <option value="2">Website</option>
        <option value="52">Welland Heritage Council</option>
        <option value="16">Western Diversification</option>
        <option value="53">Women Entrepreneurship Fund</option>
        <option value="1">Word of Mouth</option>
      </select><i class="dropdown icon"></i>
      <div class="text"></div>
      <div class="menu" tabindex="-1">
        <div class="item" data-value="60" data-text="Accel North">Accel North</div>
        <div class="item" data-value="26" data-text="AdMail Campaign">AdMail Campaign</div>
        <div class="item" data-value="48" data-text="Bank or Credit Union">Bank or Credit Union</div>
        <div class="item" data-value="3" data-text="Brochure(s)">Brochure(s)</div>
        <div class="item" data-value="43" data-text="Brock University">Brock University</div>
        <div class="item" data-value="4" data-text="Business Development Bank (BDC)">Business Development Bank (BDC)</div>
        <div class="item" data-value="7" data-text="Canada.ca - Service Canada Centre">Canada.ca - Service Canada Centre</div>
        <div class="item" data-value="49" data-text="Canadian Small Business Financing Program (CSBFP)">Canadian Small Business Financing Program (CSBFP)</div>
        <div class="item" data-value="5" data-text="CFDC - Community Futures Development Corporation">CFDC - Community Futures Development Corporation</div>
        <div class="item" data-value="8" data-text="Chamber of Commerce">Chamber of Commerce</div>
        <div class="item" data-value="9" data-text="Current/Past Client">Current/Past Client</div>
        <div class="item" data-value="32" data-text="Current/Past Prospect">Current/Past Prospect</div>
        <div class="item" data-value="6" data-text="Employment Help Centre">Employment Help Centre</div>
        <div class="item" data-value="34" data-text="Export Development Canada (EDC)">Export Development Canada (EDC)</div>
        <div class="item" data-value="58" data-text="Fair Finance Fund (FFF)">Fair Finance Fund (FFF)</div>
        <div class="item" data-value="37" data-text="Farm Credit Canada (FCC)">Farm Credit Canada (FCC)</div>
        <div class="item" data-value="35" data-text="FedDev Ontario SBS">FedDev Ontario SBS</div>
        <div class="item" data-value="45" data-text="FedDev RRRF">FedDev RRRF</div>
        <div class="item" data-value="46" data-text="Futurpreneur">Futurpreneur</div>
        <div class="item" data-value="10" data-text="Human Resources Development Canada">Human Resources Development Canada</div>
        <div class="item" data-value="44" data-text="Innovate Niagara">Innovate Niagara</div>
        <div class="item" data-value="12" data-text="Municipality &amp; EDO">Municipality &amp; EDO</div>
        <div class="item" data-value="23" data-text="Newspaper Ad">Newspaper Ad</div>
        <div class="item" data-value="33" data-text="Niagara Angel Network">Niagara Angel Network</div>
        <div class="item" data-value="42" data-text="Niagara College">Niagara College</div>
        <div class="item" data-value="40" data-text="Niagara Community Foundation (NCF)">Niagara Community Foundation (NCF)</div>
        <div class="item" data-value="31" data-text="Niagara Falls Innovation Hub (Spark Niagara)">Niagara Falls Innovation Hub (Spark Niagara)</div>
        <div class="item" data-value="29" data-text="Niagara Falls Small Business Enterprise Centre (NFSBEC)">Niagara Falls Small Business Enterprise Centre (NFSBEC)</div>
        <div class="item" data-value="41" data-text="Niagara Folk Arts Multicultural Centre">Niagara Folk Arts Multicultural Centre</div>
        <div class="item" data-value="38" data-text="Niagara Region - EDO">Niagara Region - EDO</div>
        <div class="item" data-value="47" data-text="NRC - IRAP">NRC - IRAP</div>
        <div class="item" data-value="36" data-text="OMAFRA">OMAFRA</div>
        <div class="item" data-value="57" data-text="Other">Other</div>
        <div class="item" data-value="59" data-text="PARO">PARO</div>
        <div class="item" data-value="14" data-text="Radio Announcement">Radio Announcement</div>
        <div class="item" data-value="39" data-text="SOFII">SOFII</div>
        <div class="item" data-value="50" data-text="SR&amp;ED Program">SR&amp;ED Program</div>
        <div class="item" data-value="30" data-text="St. Catharines Enterprise Centre (SCEC)">St. Catharines Enterprise Centre (SCEC)</div>
        <div class="item" data-value="51" data-text="Venture Niagara - CED">Venture Niagara - CED</div>
        <div class="item" data-value="27" data-text="Venture Niagara - Loans">Venture Niagara - Loans</div>
        <div class="item" data-value="25" data-text="Web Search and Social Media">Web Search and Social Media</div>
        <div class="item" data-value="2" data-text="Website">Website</div>
        <div class="item" data-value="52" data-text="Welland Heritage Council">Welland Heritage Council</div>
        <div class="item" data-value="16" data-text="Western Diversification">Western Diversification</div>
        <div class="item" data-value="53" data-text="Women Entrepreneurship Fund">Women Entrepreneurship Fund</div>
        <div class="item" data-value="1" data-text="Word of Mouth">Word of Mouth</div>
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    </div>
  </div>
  <div class="five wide field" data-bind="visible: $root.HearAboutUsOther" style="display: none;">
    <input type="text" name="hear-about-other" placeholder="Describe where you heard about us" data-bind="textInput: HearAboutUs">
  </div>
  <div class="ui message">
    <div class="header"> Disclaimer </div>
    <p>Please read the disclaimer in the link below before submitting:</p>
    <div class="field">
      <a href="https://www.ventureniagara.com/niagara-futures-development-corp/disclaimer/" target="_blank">https://www.ventureniagara.com/niagara-futures-development-corp/disclaimer/</a>
    </div>
    <div class="ui checkbox" data-bind="event: { click: $root.understoodDisclaimerClicked }">
      <input type="checkbox" name="understand-disclaimer" tabindex="0" class="hidden">
      <label>I confirm that I have read and understood the disclaimer</label>
    </div>
  </div>
  <div class="ui error message"></div>
</form>

Text Content

Venture Niagara/Enterprise Niagara
English
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form.

Are you sure you wish to continue?
Cancel
Change language
Getting started
Personal information
Business
Your business
Assistance
How can we help?

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PERSONAL INFORMATION

Title MrMsMrsMxDrProfRev
First name
Last name
Middle name
Gender
MaleFemaleOtherPrefer not to answer
Male
Male
Female
Other
Prefer not to answer
Phone
Email


HOME ADDRESS

Address Search

Address 1

City
Province
OntarioAlbertaBritish ColumbiaManitobaNewfoundland and LabradorNew BrunswickNova
ScotiaPrince Edward IslandSaskatchewanQuebecNorthwest
TerritoriesYukonNunavutOther
Ontario
Ontario
Alberta
British Columbia
Manitoba
Newfoundland and Labrador
New Brunswick
Nova Scotia
Prince Edward Island
Saskatchewan
Quebec
Northwest Territories
Yukon
Nunavut
Other
Postal code
Municipality
Fort ErieGrimsbyLincolnNiagara FallsNiagara-on-the-LakeOtherPelhamPort
ColborneSt. CatharinesThoroldWainfleetWelland

Fort Erie
Grimsby
Lincoln
Niagara Falls
Niagara-on-the-Lake
Other
Pelham
Port Colborne
St. Catharines
Thorold
Wainfleet
Welland


ADDITIONAL INFORMATION

How should we get in contact with you? (select all that apply)
Email Phone

Email
Phone
Subscribe to our newsletter?
Yes, I want to subscribe
Self-identifying inclusiveness (select all that apply)
EI - RecipientGeneral PopulaceIndigenous PeoplesLGBTQ2+New CanadianOfficial
Language Minority CommunityOtherPersons with DisabilitiesPrefer not to
answerSeniorsSocial Economy EnterprisesStudentVisible MinorityWomenYouth

EI - Recipient
General Populace
Indigenous Peoples
LGBTQ2+
New Canadian
Official Language Minority Community
Other
Persons with Disabilities
Prefer not to answer
Seniors
Social Economy Enterprises
Student
Visible Minority
Women
Youth
Are you the owner of a business?
Yes
No
Ownership %
%


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YOUR BUSINESS

Business name (use personal name if unknown)
Business stage
Start-upMaintenanceExpansionPurchase of existing businessSale of existing
businessOther
Start-up
Start-up
Maintenance
Expansion
Purchase of existing business
Sale of existing business
Other
Start date

2021 - 2032202120222023202420252026202720282029203020312032

Legal name
Legal type
IncorporatedNot for ProfitPartnershipProject PartnerSole Proprietorship

Incorporated
Not for Profit
Partnership
Project Partner
Sole Proprietorship
What is your primary business sector? (Type 'other' if not sure)


BUSINESS CONTACT INFORMATION

Tick if Business contact information is the same as personal contact information
Phone
Email


BUSINESS ADDRESS

Tick if Business address is the same as personal address
Address 1

City
Province
OntarioAlbertaBritish ColumbiaManitobaNewfoundland and LabradorNew BrunswickNova
ScotiaPrince Edward IslandSaskatchewanQuebecNorthwest
TerritoriesYukonNunavutOther
Ontario
Ontario
Alberta
British Columbia
Manitoba
Newfoundland and Labrador
New Brunswick
Nova Scotia
Prince Edward Island
Saskatchewan
Quebec
Northwest Territories
Yukon
Nunavut
Other
Postal code
Municipality
Fort ErieGrimsbyLincolnNiagara FallsNiagara-on-the-LakeOtherPelhamPort
ColborneSt. CatharinesThoroldWainfleetWelland

Fort Erie
Grimsby
Lincoln
Niagara Falls
Niagara-on-the-Lake
Other
Pelham
Port Colborne
St. Catharines
Thorold
Wainfleet
Welland


Note: Do not hit the refresh button as all entered information will be deleted!


HOW CAN WE HELP YOU?

What Service are you looking for?" "(select all that apply)
LoanCounsellingCommunity Economic Development (CED)Other

Loan
Counselling
Community Economic Development (CED)
Other
Please specify the other services that you are interested in
How much money will you be applying for?
$
.00
Have you recently received any other funding?
Yes
What kind of financing is your business interested in? (select all that apply)
Term loanOperating lineEquityUnsure

Term loan
Operating line
Equity
Unsure
How will you be using the funding? (select all that apply)
Working capitalEquipmentLeasehold/RenovationsExpansionMarketingProperty
PurchaseOther

Working capital
Equipment
Leasehold/Renovations
Expansion
Marketing
Property Purchase
Other
Tell us more about your business and how we can help you?
How many employees do you currently have?

How many employees do you plan to hire this year?

How did you hear about us?
Accel NorthAdMail CampaignBank or Credit UnionBrochure(s)Brock
UniversityBusiness Development Bank (BDC)Canada.ca - Service Canada
CentreCanadian Small Business Financing Program (CSBFP)CFDC - Community Futures
Development CorporationChamber of CommerceCurrent/Past ClientCurrent/Past
ProspectEmployment Help CentreExport Development Canada (EDC)Fair Finance Fund
(FFF)Farm Credit Canada (FCC)FedDev Ontario SBSFedDev RRRFFuturpreneurHuman
Resources Development CanadaInnovate NiagaraMunicipality & EDONewspaper
AdNiagara Angel NetworkNiagara CollegeNiagara Community Foundation (NCF)Niagara
Falls Innovation Hub (Spark Niagara)Niagara Falls Small Business Enterprise
Centre (NFSBEC)Niagara Folk Arts Multicultural CentreNiagara Region - EDONRC -
IRAPOMAFRAOtherPARORadio AnnouncementSOFIISR&ED ProgramSt. Catharines Enterprise
Centre (SCEC)Venture Niagara - CEDVenture Niagara - LoansWeb Search and Social
MediaWebsiteWelland Heritage CouncilWestern DiversificationWomen
Entrepreneurship FundWord of Mouth

Accel North
AdMail Campaign
Bank or Credit Union
Brochure(s)
Brock University
Business Development Bank (BDC)
Canada.ca - Service Canada Centre
Canadian Small Business Financing Program (CSBFP)
CFDC - Community Futures Development Corporation
Chamber of Commerce
Current/Past Client
Current/Past Prospect
Employment Help Centre
Export Development Canada (EDC)
Fair Finance Fund (FFF)
Farm Credit Canada (FCC)
FedDev Ontario SBS
FedDev RRRF
Futurpreneur
Human Resources Development Canada
Innovate Niagara
Municipality & EDO
Newspaper Ad
Niagara Angel Network
Niagara College
Niagara Community Foundation (NCF)
Niagara Falls Innovation Hub (Spark Niagara)
Niagara Falls Small Business Enterprise Centre (NFSBEC)
Niagara Folk Arts Multicultural Centre
Niagara Region - EDO
NRC - IRAP
OMAFRA
Other
PARO
Radio Announcement
SOFII
SR&ED Program
St. Catharines Enterprise Centre (SCEC)
Venture Niagara - CED
Venture Niagara - Loans
Web Search and Social Media
Website
Welland Heritage Council
Western Diversification
Women Entrepreneurship Fund
Word of Mouth

Disclaimer

Please read the disclaimer in the link below before submitting:

https://www.ventureniagara.com/niagara-futures-development-corp/disclaimer/
I confirm that I have read and understood the disclaimer

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THANKS, YOU'RE ALL DONE!
WE HAVE RECEIVED YOUR INFORMATION AND ONCE IT IS REVIEWED WE WILL BE IN CONTACT
WITH YOU.

Venture Niagara/Enterprise Niagara
20 Pine Street North
Studio A
Thorold, Ontario
L2V 0A1
https://www.ventureniagara.com/
(905) 680-8085
Click here to return to the Venture Niagara/Enterprise Niagara website


CONTACT

20 Pine Street North
Thorold, Ontario
L2V 0A1
https://www.ventureniagara.com/


VENTURE NIAGARA/ENTERPRISE NIAGARA

Established as a not for profit corporation in 1985, Venture Niagara is one of
61 Community Futures Development Corporations in Ontario.



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