Small Business Event Survey Your responses to this form will be kept confidential. Contact Information First Name Last Name Business Name If you do not have a business name, please leave this field blank. Business City Business Email Personal Email Phone Workshop information What workshop did you attend?Please select... Small Business Fundamentals A different workshop Please rate this workshop from 1-5 (1- not helpful, 5- very helpful)12345 What did you enjoy about the workshop? What needed improvement? What other workshops would be helpful to you? What time of day works best for you to attend future workshops?MorningAfternoonLate afternoonEvening Are you interested in 1:1 business counseling with us?YesNoUnsureNot at this time, but possibly in the futureI am already a client receiving 1:1 Counseling in the Small Business Program. Business Details What type of small business do you own? For example: restaurant, pet groomer, acupuncture What stage of Business are you in?Prospective Business Owner (about 1 year from starting a business)Pre-Startup (within one year of startup)Startup (business operating/generating revenue less than 1 year)Established Business Clients (in business more than 1 year and generating income) What business setup do you have?Please select... Business has brick-and-mortar location Home-based business Business has another arrangement Other Owners of the Business Is there another person who owns this business besides yourself?YesNo Name(s) of additional business owner(s): Email address(es) of additional business owner(s): Are you working with any other small business consultants? If so, who? What are the top 3 business goals that our Valley Community Development Small Business Consultants could help you with? By checking this box and typing my name below, I certify that the information contained herein is true, complete, and correct to the best of my knowledge and belief. I affirm that I own or am associated with the business or prospective business receiving technical assistance. Ok Name Date Formula field reCAPTCHA helps prevent automated form spam. The submit button will be disabled until you complete the CAPTCHA. Contact Us
