Client Intake Form

Full Name*

First NameLast Name

Contact Number*

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

Email Address

example@example.com

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

WomenFrancophonesIndigenous people (First Nation, Inuit or Metis)Racialized groupsBlack communitiesNewcomers to Canada (landed immigrants who came to Canada up to 5 yrs prior to a given census year)People with disabilitiesYouth under 39 years of ageLesbian, gay, bisexual, or queer, Trans or non-Binary (LGBQ2+)

YesNo

Business Name*

Those without a name can indicate 'TBD'

Main business activity*

What products/services are you planning to sell?

Position within company

Year established (or anticipated start date)

Operating Status*

Website or primary social media page (if applicable)

Legal form

Location type*

Service Area

Import/Export*

Number of full-time employees including owner(s)

Number of part-time employees including owner(s)

Preferred date/time. ***Please note: Appointments are not confirmed until you receive a meeting invitation e-mail from a member of our team.***

How would you prefer to meet?*

How did you hear about The Business Enterprise Centre or Timmins Economic Development?*

Business Registration / RenewalBusiness Plan DevelopmentFunding and Financing (grants and loans)Business Logistics (banking, insurance, legal, etc.)Hiring Employees (WSIB, Payroll, etc.)Marketing/Advertising, Social MediaAccounting/Bookkeeping, Taxation, HSTNetworking, Mentorship/CoachingOther

If other, please specify.

YesNo

Client - Consultant Service Agreement

Welcome to The Business Enterprise Centre

Congratulations on taking the first step toward realizing your dream of starting your own business. This agreement outlines how we will work together and what each party can expect throughout your business development journey.

PART 1: The Client–Consultant Relationship

Your Business Development Consultant Will:

Assist you in making informed decisions about your business idea.
Be committed to helping you reach your goals.
Explain the importance of a comprehensive business plan and help you understand each section.
Connect you with relevant business partners and support organizations.
Post updates on upcoming workshops and events.
Provide honest, attentive, and timely feedback.
Maintain confidentiality and obtain written permission before sharing your business details.
Disclose any conflicts of interest that may affect their ability to support you impartially.

Your Consultant Will NOT:

Make business decisions on your behalf.
Negotiate business deals for you.
Write your business plan (they will guide you but not create it).
Offer legal, accounting, or technical advice.
Breach your confidentiality under any circumstance.
Assume responsibility for your business’s success.

As a Business Enterprise Centre Client, You WILL:

Provide advance notice if you need to reschedule a meeting.
Arrive prepared and organized.
Present your business plan in a clear, readable format.
Track and confirm your participation in events and workshops.
Complete assigned tasks within agreed timelines.
Be open, honest, and fully engaged in the process.
Use only agreed-upon communication channels with your Consultant.

Together We Will:

Maintain a professional relationship based on mutual respect.
Uphold confidentiality, honesty, and integrity at all times.

Timmins Economic Development and its service providers (i.e. The Business Enterprise Centre) will not disclose personal information to the third parties other than in compliance with applicable federal and provincial privacy laws and, in particular the requirements for with the consent of our clients. Clients provide consent to the use and disclosure of personal information for statistical or scholarly study or research purposes, which information will be used or disclosed in such a manner that will insure its confidentiality. Timmins Economic Development does not view information that if freely available such as, but not limited to, business name(s) and contact information as personal information.

PART 2: Client Service Agreement – Ontario Business Registry Assistance

This section refers to The Business Enterprise Centre’s assistance with Service Ontario’s Ontario Business Registry for the following services:

Business Name Registration for a Certificate of Name Registration (sole proprietorships, general partnerships, or operating names under existing corporations).
Renewal of a Certificate of Name Registration.
Enhanced Business Name Search of existing registered businesses in Ontario.
Modifications or Closures of Certificate of Name Registration filings.

Important Notes:

The Centre provides guidance only. You are responsible for the accuracy and final submission of all information.
You will be given the opportunity to review and confirm all entered data before final submission.
Payment is processed electronically upon submission. The Centre cannot provide refunds.
If errors are discovered after submission, the Centre may help you contact Service Ontario but cannot guarantee outcomes regarding refunds or cancellations.

Acknowledgement and Affirmations

By acknowledging and signing below, you affirm your understanding of and commitment to the expectations and responsibilities outlined above.

I have read and understood the terms of this Agreement.I understand that I am responsible for all final decisions and submissions regarding my business.I understand that my Consultant provides guidance only and cannot guarantee business outcomes or refunds from Service Ontario.I authorize The Business Enterprise Centre to share my contact information with the Centre’s Provincial Funders for reporting purposes, as well as identified for referral purposes.I authorize The Business Enterprise Centre to contact me about future events, seminars, workshops and relevant business information through their mailing list.I authorize The Business Enterprise Centre to store my contact information, business plans and financial information provided during my participation as a general client or program participant, in their secure Customer Relationship Management (CRM) System.

Signature*