Small Business Legal Clinic - Interest Form
Thank you for your interest in the Small Business Legal Clinic (SBLC). Please fill out this survey completely and we will call within three business days.

Important! We can only serve Oregon businesses and only work with transactional legal issues (no litigation).

Information from this form is used for screening purposes only and will be used to determine your possible eligibility for SBLC services. Confidential or sensitive information should not be sent through this form. The information gathered here will not be used for any other purpose or shared without any outside organization or individual without additional authorization. Please see our privacy policy for additional information, https://law.lclark.edu/centers/small_business_legal_clinic/sblc-privacy-policy/
First Name: *
Last Name *
Business name *
Address of business *
If there is no current business address, please put your personal address
City *
State *
Zip code *
County
(such as Multnomah or Clackamas)
Telephone contact number *
Contact E-mail *
Business website
Business location
Is the business currently registered in Oregon *
Required
If the business is registered, when was it registered?
MM
/
DD
/
YYYY
Type of business: *
How long has the business been operating? *
How many owners are in the business?
If you are a non-profit corporation, please choose other.
Clear selection
Adjusted Gross Personal Income for Owner # 1 - Please give the exact number, not an estimate. (See individual federal tax return - 1040, 1040A, 1040EZ). This is NOT the company income, but the household personal income of the owner. Do not include just a portion of the income. Please state the income for the entire household. *
If you are a non-profit corporation, please write your operating budget
Adjusted Gross Income for Owner #2 (See household federal tax return - 1040, 1040A, 1040EZ) *
Required for each owner. Put in $0 if no second owner
Adjusted Gross Income for Owner #3 (See household federal tax return - 1040, 1040A, 1040EZ) *
Required for each owner. Put in $0 if no third owner.
Adjusted Gross Income for Owner #4 (See household federal tax return - 1040, 1040A, 1040EZ) *
Required for each owner. Put in $0 if no fourth owner.
How did you learn about the Small Business Legal Clinic? *
Information provided, submitted or transmitted through this form does not create an attorney-client relationship and cannot be used to preclude the SBLC from representing a client that may have a conflict of interest with you. The creation of an attorney-client relationship requires a written agreement that confirms that an attorney-client relationship has been established. *
When is a good time to contact you?
We will try to contact you at this time, but may need to call at another time depending on our schedules.
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