SBIC INTAKE FORM

he Small Business Investment Center is committed to supporting Diversity Equity and Inclusion. The SBIC gives priority to marginalized and disenfranchised entrepreneurs. In order to ensure the program’s success, we are asking applicants to self-identify. All data collected is used internally. Names and attached Responses will not be published.

COMPLETE THE INTAKE FORM BELOW

The Small Business Investment Center Intake Form

Name(Required)

First Last

Phone(Required)

Email(Required)

Business Name(Required)

What is your gender identity?(Required)

What is your race?(Required)

Do you Identify as a member of the LGBTQ+ Community?(Required)

Are you a U.S. Veteran?(Required)

Are you and your business partner(s) willing to commit to a 1 year program including the completion of three financial business education classes? (Required)

Have you gone through the Incorporation process or is this a new business concept/ idea?(Required)

If business already exists where is the business located? (Required)

Street Address City State ZIP Code

County(Required)

How long has the business been operating?

Do you or will you plan to operate the business in a commercial space?(Required)

Do you already have or do you plan to have employees in the next 2 years?(Required)

SBIC INTAKE FORM

The Small Business Investment Center Intake Form

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