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Gayle and Bill Cook Center for Entrepreneurship
Application for Business Consulting
Personal Information
First Name
Last Name
Address
City
State
Phone (primary)
Phone (cell)
Email
Company Information
Company Name
Company Email
(if different from above)
Company Phone
(if different from above)
How did you hear about us?
Chamber
Educational Institution
(Which one?)
Local Economic Development
(Please explain.)
Newspaper
(Which one?)
SCORE
Bank
(Which one?)
Word of Mouth
(Please explain.)
Internet
(What website?)
TV or Radio
(What station?)
SBA/SBDC
Other
(Please explain.)
What type of business help are you looking for?
Accounting/Records
Computer Systems
Engineering R&D
Franchising
Government Contracting
International Trade
Getting Started
Liquidation
E-commerce
Financing/Capital
Marketing/Sales
Personnel
Patents/Copyrights
Sources of Capital
Other
(please explain)
Please explain your business/business idea and describe your most important needs.
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