Small Business Request for Assistance Form
The Greater Durham Black Chamber of Commerce (GDBCC) is a nonprofit organization that works with many partners (the SBA, USBC, Durham County, Wells Fargo, etc.) to provide free counseling, training, and 1:1 technical assistance to area businesses.  Please fill out the form below to request entrepreneurial or business assistance. 

By filling out this form, you are requesting business counseling service from the GDBCC. Please note that any information disclosed will be held in strict confidence. The GDBCC will not provide your personal information to commercial entities. By filling out this form, you hereby authorize the GDBCC to furnish relevant information to the assigned management counselor(s). You also further understand that the counselor(s) agrees not to: 1) recommend goods or services from sources in which they have an interest, and 2) accept fees or commissions developing from this counseling relationship. In consideration of the counselor(s) furnishing management or technical assistance, you hereby waive all claims against the GDBCC personnel, and that of its partner organizations, arising from this assistance.

Please fill out the form below to request assistance.  We will respond to all inquiries within 2 business days.  
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Email *
Name *
Business Name *
Are You the Business Owner *
Phone Number
Date Business Started/Incorporated *
MM
/
DD
/
YYYY
Is this business a home-based business or do you have a physical location?
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Mailing Address (Include Street, City, and Zip) *
Business Entity Classification
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What is your product or service? 
How many employees does the business have (including you)
Does your business currently have monthly bookkeeping and generated reports?
Clear selection
Approximate Annual Revenue
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Enter Military Branch if Applicable
Ethnic Group
Clear selection
Assistance Required (Check all that apply)
Is there any other information or context that you would like to provide on the assistance you are seeking?
A copy of your responses will be emailed to the address you provided.
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