Small Business Counseling – Make an Appointment - New York SBDC

Please note: The information gathered on this form is kept strictly confidential. Your information is only used by SBDC staff and NOT made public, shared or available to third parties.

Contact information: (Items with * are required)  

Are you Federally
debarred or suspended?
:*
 
More information on Suspension and Debarment
First Name:*
Last Name: *
Business Name: *

Product or service description:*
Address:*
 
City:*
State/Province:*
Zip:
Country
Email Address:*
Phone Number:*  
Best Contact Method:
Best time for contact:
Race :*
Self-Described Race:
Are you disabled? :*
Veteran Status :*
Branch of Service:
SBA Client (Past or Present):*
Counseling Type:*
Website Address:
Request for counseling information*
Describe the nature of the counseling you are seeking

Business Information:
Currently in Business? *  

Would you like to tell us more about yourself and/or your business? 
Fill out the optional fields below to better prepare your advisor for your meeting. 


Select the county you wish to receive counseling in (required):

PLEASE NOTE: If you are in New York City, the following counties correspond to the five Boroughs:
Manhattan - New York
Bronx - Bronx
Brooklyn - Kings
Queens - Queens
Staten Island - Richmond

 * 


New York State Small Business Development Center Client Disclaimer (Required)

I request management assistance from The New York State Small Business Development Center. I understand that this assistance is free of charge and that I incur no obligation to The New York SBDC or the U.S. Small Business Administration or its counselors for providing this assistance. I agree to cooperate should I be selected to participate in surveys designed to evaluate assistance services. I authorize the New York SBDC to furnish relevant information to the assigned management counselor(s) although I expect that information to be held in strict confidence to the extent allowable by law.

I further understand that any counselor has agreed not to: (1) recommend goods or services from sources in which he/she has an interest and (2) accept fees or commissions developing from this counseling relationship. In consideration of the SBDC, in cooperation with the SBA furnishing management or technical assistance, I waive all claims against The New York State SBDC, SBA, personnel or counselors arising from this assistance.





    Cancel