HCC Small Business Center-Minority Business Form

Are you a minority business owner? We’d love to hear from you

You don't have to fill in all the information, but the more information we have, the better we'll be able to help.

Name First:		Last
Company Name:
Street Address:		City:
	State: Zip:	Email:
Phone Number(s):		Fax:
Website:
Minority Designation:	Male: Female: Handicapped: Ethnicity:
Needs and Challenges You Face:
How Can We Help You Grow Your Business?
Do you have a current business plan?	Yes: No:
Would you like help developing a business plan?	Yes: No:
Would you like to be part of an area database to promote minority business? From time to time you'll also receive information about improving your business.	Yes: No:
Other Comments:

Click this button once when you are through.

HCC Contact Information:
Dick McCormick, Director, Small Business Center
252-536-7274 mccormickr@halifaxcc.edu