First Name

Last Name

Company Name (if applicable)

Phone Number


Website Address (if any)

Are you in business now?

If in business, how long?

Is your home located in Dallas County?

Is, or will your business be located in Dallas County?

If no, what county?

If you are in business now, what were your annual sales for the past year?

If you are in business now, what was your net profit for the past year?

Describe the business you have.
Describe the business you are considering starting.

Describe the kind of help you need.

Which of our locations do you prefer to visit for your counseling session?

Do you need financial resources, such as a loan to start your business or expand?

If yes, how much money do you need to start or grow your business?
$0 - $1,000$1,001 - $5,000$5,001 - $10,000$10,001 - $25,000$25,001 - $50,000$50,001 - $100,000$100,001 - $250,000More than $250,000Unknown

How would you rate your personal credit history?

Do you know your credit score?

If yes, what is your score?

Do you have savings or other financial resources that you will invest towards starting or growing your business?

If yes, what is the total dollar amount?

How did you hear about the Dallas Metropolitan SBDC?
Bank/LenderChamberClient/Word of MouthCollege/UniversityCounty/CityGovernmentInternet SearchLocal Economic DevelopmentSBASBDCTraining SeminarSCORESocial Media/Blog PostOther

If OTHER, who?

Are you a WINGS Member?

Are you a part of WINGS Womens Enterprise program?

Are you a part of WINGS IDA Savings Program?

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