Business
Name of Company
Address
City
State
- State -
AL
AK
AS
AZ
AR
CA
CO
CT
DE
DC
FL
GA
ID
IL
IN
IA
KS
KY
LA
ME
MD
MA
MI
MN
MS
MO
MT
NV
NH
NJ
NM
NY
NC
ND
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VT
VA
WA
WV
WI
WY
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.