Business
Name of Company
Address
City
State
Zip
Phone Number NNN-NNN-NNNN
Fax Number NNN-NNN-NNNN
Email
Web Address
Please indicate with an X the neighborhood in which your business operates
Wynwood Little Haiti
Allapattah Liberty City
Overtown Flagami
Little Havana    
   
Nature of Business
Retail  
Gifts and Clothing Graphic Arts
Grocery Other
Wholesale Distribution  
Hardware Grocery
Other    
Services  
Financial Personal
Other    
Other Business:
   
Type of Organization
Sole Proprietorship Minority
Partnership Female Ownership
Male Ownership Other:
   
Business Statistics
Number of Employees
1-5 6-20 20 +
Revenue per Year
Less than $30K $30k - $100k $100K +
Number of Years in Business
6 months - 1 year 1 - 5 years 6 years +
           
Attendee First Name
Attendee Last Name
Attendee Title / Position
Attendee Telephone NNN-NNN-NNNN
Attendee Email
   
By submitting this application, I commit to attend the Financial Literacy Seminar and the Community Forum.
Applications will be reviewed and selected applicants will be notified by the Small Business Education Program Office.