Apply for TechSource Integrate

Name

Company

Title

Address

Phone

Website

Sales Tax License Number

Business Start Date

Business Type

NAICS Code(s) if known

Business Organization

Number of Company Locations - In state

Number of Company Locations - Out of State

Percentage of Physical Assets - In State

Percentage of Physical Assets - Out of State

Gross Sales for the past 2 years

Projected gross sales for the next 2 years

Net income for the past 2 years

Projected net income for the next 2 years

Number of FTE the past 2 years AND percentage which were employed in Colorado

Projected number of FTE for the next 2 years AND percentage employed in Colorado

Owner Operated?

Yes No

Home Based?

Yes No

Franchise?

Yes No

Is there a current business plan?

Yes No

Please briefly describe your company and the backgrounds of founders and key management team

Please identify 1 to 3 key issues you think will be important to discuss with the SBDC TechSource team- list by priority

Please describe your planned outcomes from participation in this program (may include business goals, action items, or specific activities)

How did you hear about the program? If referred, by whom?

By entering your name here, you are indicating that the above statements are true and correct, and acknowledge that you are electronically signing this application form