BBA Supplier Scale Application Form

Small Business Advisory Services

Supplier Scale Program Application

The Birmingham Business Alliance has partnered with Interise, a national not-for-profit with award-winning small business programs, to offer Supplier Scale.

This program of the Business Advisory Services initiative is made possible thanks to generous funding from Jefferson County and Prosper, and will serve at least 20 local and diverse small businesses that are close to landing their first or second contract but could use additional assistance.

Join a committed group of business owners for interactive class sessions, peer mentoring groups, and the opportunity to learn from local experts in the fields of finance, marketing, and procurement. Complete the program with a customized, three-year strategic growth plan: plus, the confidence and ability to turn those plans into action.

This application will take approximately 20 minutes to complete. Once you begin the application, you must complete all required fields; partially completed applications cannot be saved or submitted.
Business Name*
Applicant Name*

First NameMiddle NameLast Name
Business Address*

Street Address

Street Address Line 2

CityState

Postal / Zip Code
Business Phone*

Area CodePhone Number
Cell Phone*

Area CodePhone Number
Email Address*
Website*
Industry*
Referred by*
Race/Ethnicity:*

American Indian or Alaska NativeAsianBlack or African AmericanNative Hawaiian or Other Pacific IslanderWhitePrefer not to answerOther
Are you Hispanic/Latino?*

Yes, I am Hispanic/Latino.No, I am not Hispanic/Latino.Prefer not to answer
Are you certified with the following agencies?*

Alabama Office of Minority/Woman-Owned Business Enterprise (OMBE) CertificationWomen’s Business Enterprise Council (WBEC) South (WBE)Southern Region Minority Supplier Development Council (SRMSDC) (MBE)Alabama Department of Transportation (ALDOT) Disadvantaged Business Enterprise (DBE) CertificationN/A, I have no certifications
Please list all other certifications:
What business programs have you completed?*
What business programs are you participating in now?*
Please provide a brief description of your business:*
What month and year did you start/buy your business?*
Are you the 100% owner?*

YesNoOther
Number of full-time employees: *
Number of part-time employees: *
Estimated annual revenue from last calendar year: *
Where do you hope to see your business in three years?*
How do you plan to make time to participate in the program? *
This program, valued at $15,000, is being provided for you by the Birmingham Business Alliance so that you can grow and sustain your business.

Questions? Contact: JC Matthews, 205-241-8116, jcmatthews@birminghambusinessalliance.com
Should be Empty: