1Berkshire Economic Development Team Intake Form
Please fill out this form ahead of your meeting with us to help us become more aware of your needs and resources with which we might be able to connect you. Our business consultation services are free of cost and confidential, but the information you provide below will help us tailor your consultation to your needs and will help us track our impact.

IMPORTANT: Upon submission of this form, please follow the link that appears on the submission confirmation page to schedule your respective consultation time. 

NOTE: Unless otherwise specified/coordinated, all intake consultations will be via Zoom Video Conference. In-person consultations are limited to Tuesdays and the request for an in-person meeting should be conveyed to us at EconomicDev@1Berkshire.com upon booking your times lot. 


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Email *
Please provide your first and last name. *
What is the name of your business or proposed business? *
These next  demographic questions are required for our federal funding reporting. At no point will individual demographic data be shared. Data will only be shared in aggregate to ensure programs are adequately reaching a representative diversity of participants. While the questions are "required" please feel free to utilize the "Unsure/Prefer not to answer" at any time.
What do you identify as? *
Which of the following most closely matches your racial identity? *
These categories are based on census data points set forth by federal funding guidelines
I am *
I am *
I identify my business as: (please check ALL that apply) *NOTE: This information is only so we can help provide added resources and support as available and to make sure we are supporting as wide a breadth of entrepreneurs as we can* *
Required
If you hold a certificate for any of the following, please check all that apply. NOTE: You may have checked boxes in the previous question but still not be "certified" by the state. This question is specific to certificates held.
Please briefly describe your business or proposed business. *
What is your business' or proposed business' address? (Please include city/town) *
How much private money has been invested so far? This includes any of your own funds you have invested in the business. *
How many employees does your business have? *
How many jobs has your business created so far? *
If already in operation, how many jobs does your business hope to save, if any?
What help are you interested in receiving? *
If you had the opportunity to receive free one-on-one technical assistance in the following areas, which if any would be the most helpful to you and your current business needs?
Do you consider your business to be "tech" or "tech enabled"?

Definitions:
Tech Business - a business that primarily focuses on physically producing and/or manufacturing a new technology or product, or is centered around a digital or online product or offering.

Tech Enabled - a business that is not centered entirely around a digital or tech focus, but does have interest in expanding their online presence, use of various technologies, or expanding business in a way that adds more focus on technology and advanced manufacturing.
 *
Would you be interested in being added to a specific 1Berkshire Economic Development network email list? *
Is there anything else we should know before your consultation meeting? *
A copy of your responses will be emailed to the address you provided.
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