Business Needs Assessment

Business Needs Assessment Survey
(* Required fields)
Contact Name: *
Title:
Business Name: *
Business Address: *
City: * State: Zip Code: *
Phone # * Ext.
Fax #
E-mail: *
Web Site:
Federal Tax ID #:
Standard Industry Code (SIC or NAICS):

Company’s product or service:
Years in business:
Corporate/headquarters
Branch
# of Employees at this location
What is the most significant factor affecting your business?

Current BUSINESS ASSISTANCE needed (that could be provided through our partners or collaborators):
Marketing Financing/Access to capital
Labor Market Information Relocation Incentive
Business counseling Import/Export information
Tax Credit information Entrepreneurial information Other
What changes do you foresee in the next year?

What type of training do you provide for your employees?
Current TRAINING and HUMAN RESOURCES assistance needed:
Retention assistance
Conference room
Current employee training
(topics):

All information given is kept confidential. None of your information will be sold or distributed to any second parties without your permission.