Business Address - Please type in street, city, state and zip code *
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Telephone Number *
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Website or Facebook Page Address *
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Business Contact Name *
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Business Opening Date *
MM
/
DD
/
YYYY
Are you currently in operation? *
Hours of Operation *
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Brief Description of Business *
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Number of Employees, including self *
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Type of Business *
Are you currently a client of the SBDC? *
If selected, which marketing programs are you most interested in for your business? This is not a commitment *
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BY MY TYPED NAME I VERIFY: (1) THAT THE INFORAMTION IN THIS APPLICAATION IS ACCURATE TO THE BEST OF MY KNOWLEDGE AND (2) THAT I HAVE THE AUTHORITY TO SUBMIT THIS APPLICAITON ON BEHALF OF THE NAMED BUSINESS.
Please type your name below to act as your electronic signature
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A copy of your responses will be emailed to the address you provided.