Business Assistance Providers for Centro's App
This form is to collect information from business technical assistance providers interested in being included in Centro's App. The App will allow providers to be found by local entrepreneurs. This form takes 5 minutes to complete. Thank you!
Organization's Information
Organization's Name *
Please attach a high-quality logo with transparent background
Main Contact Name *
Main Contact Email
Main Contact Phone
Email address where leads should be sent to *
One-sentence organization summary *
10 words maximum
Community Served
Zip Codes Served or City/County/State *
Do you have any income level restrictions?
Main Population(s) Served
Support Provided
Types of Support Provided *
Required
Clients' Business Stage *
Required
Languages *
Required
What is the minimum cost of your programs? *
What is the maximum cost of your programs? *
Do you have a sliding scale and/or payment plan?
How do you support your entrepreneurs? *
Required
Do you have anything else you'd like to share with us?
Submit
Never submit passwords through Google Forms.
This form was created inside of Centro Community Partners. - Terms of Service