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What type of help do you need for your business?:* What type of help do you need for your business? is Required

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If you did not complete high school, what was your last grade completed?:* If you did not complete high school, what was your last grade completed? is Required

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What is the name of your current employer? (If none, put :* What is the name of your current employer? (If none, put is Required

What was/is your job title and duties? (If none, put :* What was/is your job title and duties? (If none, put is Required

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In 2 to 3 sentences, briefly describe your business:* In 2 to 3 sentences, briefly describe your business is Required

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If your business has already started, enter your business start date. An estimate is fine.:* If your business has already started, enter your business start date. An estimate is fine. is Required

Do you have a business plan?:* Do you have a business plan? is Required

Business facility:* Business facility is Required

Income generated by your business at this time is your::* Income generated by your business at this time is your: is Required

How many FT + PT employees do they have:* How many FT + PT employees do they have is Required

MWBE certification status:* MWBE certification status is Required

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What percentage of your business is owned by a woman?:* What percentage of your business is owned by a woman? is Required

Legal Entity:* Legal Entity is Required

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How many employees do you have, including yourself?:* How many employees do you have, including yourself? is Required

Business Gross Revenue for the last year:* Business Gross Revenue for the last year is Required

Are you currently exporting?:* Are you currently exporting? is Required

If yes, what is your business revenue amount related to exported?:* If yes, what is your business revenue amount related to exported? is Required

If yes, what number of your employees engage in exporting?:* If yes, what number of your employees engage in exporting? is Required

If yes, what countries/territories do you export to?:* If yes, what countries/territories do you export to? is Required

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