2025 Marketing Counseling Request Form & Counselor Notes

MCBL Marketing Counseling Request Form & Counselor Notes
Thank you for your interest in receiving marketing counseling through the Patsy T. Mink Center for Business & Leadership (MCBL). Please fill out all fields completely. Consultations are confidential and are scheduled for 1 hour. Be prepared to discuss your priority questions and take notes to retain the information.

Our counseling rates for 2025 are as follows:
- 1st session – $30/hour
- 2nd session – $60/hour
If cancellation is received within 24 hours of the appointment, a $25 fee may be charged.

We are currently offering remote business counseling by Google Meet at this time.

NOTE: By participating in these services, you agree to provide feedback via periodic surveys. Mahalo in advance for helping us 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.
Have you received business counseling through the Patsy T. Mink Center for Business & Leadership (MCBL) at YWCA Oʻahu before?*

YesNo
Is your business registered with the Hawaii State Department of Commerce and Consumer Affairs (DCCA)? To check if your business is registered, visit: https://hbe.ehawaii.gov/BizEx/home.eb*

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?

MonthDayYear
Date
If YES, what is your business entity type?

Sole proprietorshipLimited liability company (LLC)C CorporationS CorporationPartnershipNonprofit organizationOther
What type of business or business idea do you have?*

ProductServiceBoth
Please describe your business or business idea. 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.*
FOR OFFICE USE ONLY
Date of business counseling session

MonthDayYear
Date
Counselor name (check all that apply)

MCBL RSMCBL Program CoordinatorOther
Type of counseling session

InitialFollow-up
Start time

Hour Minutes

AM/PM Option
End time

Hour Minutes

AM/PM Option
Contact type

PhoneGoogle MeetZoomIn-person/face-to-faceEmailOther
Counselor notes
Client action items
Candidate for MCBL programs (check all that apply)

Build Your Shopify WebsiteLaunch My Non-ProfitPatsy T. Mink Leadership AllianceWahine RisingWE by Rising TideYWahine In Business IncubatorNone
Candidate for other programs (check all that apply)

HiSTEPMBDA Enterprising Women of Color Business Center/AcceleratorShop Small HawaiiNoneOther
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MCBL Marketing Counseling Request Form & Counselor Notes

FOR OFFICE USE ONLY