Small Business New Client Intake Profile

Which best describes you?*

I have an idea for a business I'd like to start.I just started a business and I am not active yet.I am a business owner and my business is active and operating.I am a business owner and my business is not active.Other

What is your business idea?*

Business Name*

EIN #

Business Address

Business Address*

Street Address

Street Address Line 2

CityState

Zip Code

DUNS #

NAICS #

Business Phone

Please enter a valid phone number.

Business E-Mail

example@example.com

Type Of Business

Business Website

Do you have a business plan?

YesNo

Is your business MBE or WBE Certified?*

YesNo

What type of products do you sell?

What type of service do you provide?

Do you sell products or provide a service?*

Sell ProductsProvide a ServiceI sell products and also provide a service.

Industry*

Estimated Revenue in 2023

Type Of Business

Industry

i.e. Hospitality, Beauty, Food Services, Construction, etc

How many full time employees do you have?

How many part time employees do you have?

When did you start your business?

Date

Who are your primary customers?

What are the main challenges/ obstacles your business faces?*

Are you interested in the Verizon Small Business Digital Ready Program?

Yes, I would like to learn more.No, not at this time.

Why did you start your business?

What are your plans for growth and expansion over the next 2 years?

Please list any other needs or expectations.

Business Owner Signature

If you have any questions or to schedule an appointment, please call 401-383-1179 or e-mail smallbizhelp@ribba.org.

New Client Business Profile

New Client Business Profile