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 ZipOK to Refer to Tech Asst Partner:–None–YesNoTech 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:
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
Zip
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: