Washington (MBDA) Business Center -Online Assessment-OC
Please note:  The Washington MBDA Business Center CRRP collects your personal information for purposes of this program and does not intentionally sell, share, or distribute your personal information to third parties, except as required by law.

The purpose of this contact form is for the Washington MBDA Business Center staff to connect with you to assist with your business technical assistance or advisory services needs and to help your business recover from the COVID-19 pandemic.
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Email *
Business Name
First Name *
Last Name *
% Ownership
Business Address
City *
State *
Zip Code *
Phone #
Email Address *
Website *
Operating Since *
I have a..............
How Many Years Have You Been In Business? *
Which of the following certifications does your business have?
Your Ethnicity (the Coronavirus Response & Relief Program is open to all ethnicity types - this information is used for data purposes only)
UBI #
Federal ID# (EIN)
NAICS Codes-Primary
NAICS Codes - Secondary:
2021 Annual Revenue? *
Have you filed business taxes for 2021 ? *
Do you have a current Profit & Loss statement for 2022? *
Do you have a current Balance Sheet for 2022? *
Business Type
Industry
How Many Minority Employees Do You Have Including Yourself?
Please specify the types of resources you are seeking to help your business recover from COVID-19 pandemic business disruption. *
Required
Thank you. You can also learn more about the MBDA program and services available through the Washington MBDA Business Center at: http://www.mbda-tacoma.com
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