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First Name Last Name Title Company Alt Business Name: Email Phone Street City State/Province (text only) AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingAmerican SamoaGuamNorthern Mariana IslandsPuerto RicoUnited States Minor Outlying IslandsVirgin Islands
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OK to Refer to Tech Asst Partner:–None–YesNo
Tech Assist Grouped: Access to Capital: Accounting/Payroll/Record Keeping: B2B Referrals/Opps: Biz Pivoting – New Products/Services: CashFlow Management/Forecasting: Coaching – Strategy & Biz Plan Dev: COVID-19 Guideline/Code Compliance: Legal Services: Marketing Tools/Support: Procurement/County Certification: Real Estate- Biz Expansion/Site Location: Talent & Workforce Assessment: Technology Maximization: Training/Workshops: C19 Additional Info: Questions Requiring Email Response: