South Shore Buds Mentorship Program

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

The SSB Mentorship Program will be available to past and present residents of identified areas of disproportionate impact, Economic Empowerment applicants, and Social Equity applicants. Please complete the form below to submit an application for review.

Email *

First and Last Name *

Phone Number (123-456-7890) *

Please select the one that best applies to you *

Economic Empowerment /Social Equity Participant Number

Are you a past or present resident of the geographic “areas of disproportionate impact,” which have been defined by the Cannabis Control Commission and identified in its Guidance for Identifying Areas of Disproportionate Impact? *

Yes

Required

City / Town of Residence *

Areas of interest *

Cultivation

Delivery

Manufacturing

Transportation

Retail

Required

Tell us about yourself! *

How would you like us to contact you? *

Phone

Send me a copy of my responses.

Submit

Clear form

Never submit passwords through Google Forms.

reCAPTCHA

Privacy Terms

This form was created inside of Bud & Mary's. Report Abuse

Forms