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Toledo Chamber
Covid19
About the Chamber
>
Vision, Mission, History
Diversity Statement
Key Objectives
GEO Program
Board
Staff
Directions to Office
Become a Member
>
Membership Application
Benefits of Membership
>
MEWA
Products and Services
>
COSEMEWA
Creating Networks
Advocacy and Public Policy
Growth Opportunities
Talent Attraction & Retention
Events Calendar
Membership Directory
Newsroom
>
Member News
Newsletter Archives
Members Only Portal
Contact Us
Reboot
Member Resources
Webinars
PPE Suppliers
Business Resources
Small Business Development Center
>
Learning Center
Client Counseling Request
Ohio SBDC Export Assistance Network
>
Export Success
Toledo Area Small Business Association
Business Development Resources
Business Connect Submit
Minority, Women and Disadvantaged Business Enterprise Directory
Emergency Preparedness Resources
>
CoronaVirus Communication SignUp
Advocacy & Public Policy
Public Policy Agenda
Regional Elected Officials
Campaign Central
Institute for Leadership & Advocacy
Boards and Commissions
Veterans Resources
Talent & Workforce
Chamber Recruiting Services
EPIC
Opportunity Accelerator
REDI
Summer In the City
Talent Attraction
Workforce Development
Toledo Region
Regional Information
Visiting
Relocating
Job Board
Community Calendar
Toledo Region Data Center
Industry Employment
Industry Forecast
Unemployment
Median Income
Migration
Occupation Forecast
Employment by Occupation
Average Industry Pay
Firm Size
Per Capita Income
Per Capita GDP
Poverty
Site Map
Blog
U.S. Small Business Administration Counseling Information Form
*
Indicates required field
Name
*
First
Last
Email
*
Phone Number
*
Address
*
Line 1
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City
State
Zip Code
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I request business counseling services from the Small Business Administration (SBA) or an SBA Resource Partner. I agree to cooperate should I be selected to participate in surveys designed to evaluate SBA services. I permit SBA or its agent the use of my name and address for SBA surveys and information mailings regarding SBA products and services.
*
Yes
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I understand that any information disclosed will be held in strict confidence. (SBA will not provide your presonal information to commercial entities.) I authorize SBA to furnish relevant information to the assigned management counselor(s). I further understand that the counselor(s) agrees not to:
recommend goods or services from sources in which he/she has an interest, and
accept fees for commissions developing from this counseling relationship. In consideration of the counselor(s) furnishing management or technical assistance, I waive all claims against SBA personnel, and that of its Resource Partners and host organizations, arising from this assistance.
Use of Information:
The information in this form is to be provided by individuals and business seeking technical assistance services from the Small Business Administration (SBA) or an SBA Resource Partner. The information is collected to help SBA's continuing improvement of business counseling programs, to ensure effective oversight and management of entrepreneurial development programs and grants, and to meet Congressional and Executive Branch reporting requirements. The form should be submitted at the site of service to the counselor providing the service. Resource Partners will submit information to SBA according to the terms of their notice of award.
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*
Date
*
Submit