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Business Information

(If you do not have official business information, enter your personal information.)

Business Name

If you do not have a business name, please leave this field blank.

Business Address

Please include apartment or suite number if applicable.

Business City

Business State

Business Zip Code

Business Phone Number

Business Email

Other Owners of the Business

Is there another person who owns this business besides yourself?

YesNo

Name(s) of additional business owner(s):

Email address(es) of additional business owner(s):

What stage of Business are you in?

Prospective Business Owner (about 1 year from starting a business)Pre-Startup (within one year of startup)Startup (business operating/generating revenue less than 1 year)Established Business Clients (in business more than 1 year and generating income)

Combined Household gross annual income:

Your gross annual income is required data needed to fund our Valley Community Development Small Business Program. Your data is only shared for reporting purposes and we prioritize our clients' confidentiality. Please enter a number only, with no characters.