Company Name
First Name
*
Last Name
*
Gender
N/R
Male
Female
Race
No Response
Native American/Alaskan Native
Asian American
African American or Black
Native Hawaiian/Pacific Islander
White
Ethnicity
No Response
Hispanic
Non-Hispanic
Legal Entity Type
No Response
Sole Proprietorship
S-Corporation
C-Corporation
Limited Liability Company (LLC)
Partnership
501(c)3
Other
Not formed yet
Currently In Business?
N/R
Yes
No
Month/Year Started
Month year picker
empty
Jan
Feb
2017
2022
Mar
Apr
2018
2023
May
Jun
2019
2024
Jul
Aug
2020
2025
Sep
Oct
2021
2026
Nov
Dec
<
>
Today
OK
Cancel
Address
Address 2
Zip Code
*
Website
Email
*
Work Phone Number
*
Mobile Phone Number
Type of Assistance Requested
No Response
Accounting/Budget
Business Management
Business Plan Assistance
Buy/Sell Business
Cash Flow Management
Certification
Concept Research
COVID-19 General Support
Customer Relations
eCommerce
Entity Formation (f.p.)
Entity Formation (non-profit)
Entity Formation Analysis
Equity
Feasibility Study
Franchising
Grants, Free
Grants, Technology
Human Resources
Insurance/Benefits
International Trade
Legal Issues
Loans
Marketing/Sales
Mentoring
Non-profit Issues
Other
Procurement
Product Development
Property Development
Regulatory Compliance
Site Location Assistance
Start up Assistance
Tax Planning
Technology/Computers
How can we help you?
*
Business Stage
No Response
Pre-Venture
Existence / Infancy
Early Growth Stage
Expansion Stage
Maturity
Decline
Sales Scope
Locally
Yes
No
Regionally
Yes
No
Nationally
Yes
No
Internationally
Yes
No
Federal Government
Yes
No
Business Ownership
Woman Owned
Yes
No
Minority Owned
Yes
No
Veteran Owned
Yes
No
Disabled Owned
Yes
No
Immigrant Owned
Yes
No
Internally Displaced Person Owned
Yes
No
Justice Involved Citizen Owned
Yes
No
Refugee Owned
Yes
No
LGBTQ+ Owned
Yes
No
Youth Owned
Yes
No
Low to Moderate Income Owned
Yes
No
Spam Protection
*