Small Business Development Center

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small business development center | el paso, texas

Client Intake Form

In order to receive our free business counseling services, the following form should be filled out and submitted. All information is kept in strict confidence. You will be contacted within one business day. For information on our services click here.

A. Contact information
Name of Your Company:	(if applicable)
Company Contact Person:
Title of Contact Person:
Name of Business Owner:
Business Website Address:
E-mail Address:
Business Phone:
Home Phone:
Fax:
Prefered Contact Method:	Phone E-Mail
Address:
Address Line 2:
City:
State:
Zip:
County:
B. Demographic information
Business Size:	Disadvantaged Small Disadvantaged SBA 8(a) Small Woman-Owned Small Minority-Owned Small Other Small Large Not In Business
Business Type:	Manufacturer/Producer Service Establishment Retail Dealer (Type I - Maintains Own Inventory) Retail Dealer (Type II - Does Not Maintain Own Inventory) Wholesale Dealer (Type I - Maintains Own Inventory) Wholesale Dealer (Type II - Does Not Maintain Own Inventory) Construction Concern Research/Development Surplus Dealer Not in Business
Organization Type:	Individual Partnership Non-profit Org. Corporation Limited Liability Co. Sub S Corporation
State of Incorporation:
Are you Interested in or Involved in International Trade?	Yes NO
Are You Disabled?	Yes NO
If So, What Is Your Type of Disablement:	(if applicable)
Whe Was Your Business Established? (mm/dd/yy):	(if applicable)
No. of Employees:	full time part time
What Is Your Ethnicity:
What Is Your Gender:
What Is Your Military Status:
Are You An SBA Client? (past or present):
CAGE:	(Optional)
DUNS:	(Optional)
What Is Your Business Status:	Pre-venture In Business
Some Special Questions (If Applicable):	Are You A Home-based Business? Are You Receiving Aid to Families with Dependent Children? Are You Receiving Temporary Assistance to Needy Families? Do You Reside In A HUBZone? Do You Reside In A Certified HUBZone?
How Did You Learn About The SBDC? Referral By:
Your Standard Industrial Classifications (SICs):	(Optional)
Your Product Service Codes (PSCs):	(Optional)
Your NAICSs:	(Optional)
Describe Your Products or Services:
Have You Visited Another SBDC Center?:	Yes NO
If so, which one?
Please Indicate the Assistance or Services Needed:

If you have any questions or comments about our services, please call the El Paso SBDC Director at (915) 831-7744 or the Regional SBDC Director at (210) 458-2450.

El Paso SBDC Client Rights and Obligations

Small
Business
Development
Center
915.831.7743

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