First Name:Click here to enter text. Last Name:Click here to enter text.

Street Address:Click here to enter text. City:Click here to enter text.

County: Click here to enter text.
Gender: Male☐ Female☐
Date of Birth: Click here to enter your D.O.B. / Zip Code:Click here to enter text.
Home Phone:Click here to enter text.
Cell Phone:Click here to enter text.
Email address:Click here to enter text.
I am:
☐Non-native
☐Member of the Quinault Indian Nation
☐Member of the Hoh Tribe
☐Member of the Quileute Nation
☐Member of the Makah Tribe
☐Member of the Lower Elwha Klallam Tribe
☐Member of the Jamestown S'Klallam Tribe
☐Member of the Shoalwater Bay Indian Tribe
☐Member ofanother tribe [MS1]Click to enter name / My business idea is:
☐A new business
☐A new product/service of an existing business
The primary location of my business is/will be:
☐Wahkiakum County
☐Pacific County
☐Grays Harbor County
☐Jefferson County
☐Clallam County

Please attach a written response to the following five questions. Responses should be typed, with at least 10point font with 1 inch margins. Your responses to these questions may not exceed 5 pages total. Any pages beyond the 5-page limit will not be considered.

  1. What products or services will be offered by your business?
  2. Who will buy your products and services and why?
  3. How will you ensure that money spent by the business and money earned by the business stays local?
  4. How will your business contribute to conservation and the sustainable use of natural resources?
  5. How will your business contribute to the development of leadership and self-determination in your community?

By submitting this application, I agree to comply with the competition rules and guidelines posted on the Coast Works website (). If I am selected as a finalist, I agree to participate in the business training, present my business case to the judging panel at the pitch event, and attend the award ceremony on the dates set forth on the Coast Works website. If I am selected as a finalist, I hereby grant permission to Coast Works to use my name, a brief description of my business idea and my photograph.

Signature: ______Date: ______

Please send your applicationby mail to the Coast Works Competition Administrator, Center for Inclusive Entrepreneurship, 220 Second Avenue South, #126, Seattle, WA 98104, or by email to the Competition Administrator at as a single PDF document including your name in the file name (example: contestantname.pdf) and including “Coast Works Competition” in the subject line. The Coast Works Application must be received by the Coast Works Competition Administrator by the application deadline to be considered for the competition. No late submission will be accepted.

[MS1]Jamestown-Sklallam? Lower Elwah?