Business Banker Counseling Request Form

Thank you for your interest in receiving business banker counseling through the Patsy T. Mink Center for Business & Leadership (MCBL). You will be assigned to a qualified business banker counselor based on your needs described below. Please fill out all fields completely. Consultations are confidential and are scheduled for 30 minutes. Be prepared to discuss your priority questions and take notes to retain the information.

Businesses interested in banker counseling must be in operation for a minimum of 1 year and currently open for business.

We are currently offering remote counseling by phone at this time.

NOTE: By participating in these services, you agree to provide feedback via periodic surveys. Mahalo in advance for helping us to fulfill our vital mission to support local small businesses.

Name*

First NameLast Name

Email*

example@example.com

Phone number*

Please enter a valid phone number.Format: (000) 000-0000.

YesNo

If YES, what is your legal business name?

If YES, what is your "doing business as" (DBA) name, if any?

If YES, what is your business registration date?

Date

ProductServiceBoth

Please describe your business. Do not disclose any confidential or proprietary information.*

Business website, if applicable

Business social media handle(s), if applicable

Please list the questions and/or topics you wish to discuss. Be as specific as possible.*

MCBL Business Banker Counseling Request Form