Contact Information

Name

    

Business Name

    

Street Address

     

City

    

Zip Code

    

Impact and Outcomes Resulting from SBDC consulting engagement

How did the SBDC help your business:

 
Did the SBDC help you in receiving financing?  
 
If the SBDC helped you in receiving financing, how much did you receive?       
How much money did you put into the business?   
How much have your sales increased since working with the SBDC?   
How many jobs have you created since working with the SBDC?   
If applicable, How many jobs have you saved since working with the SBDC?   
Did the SBDC help you develop a Business plan?  
 
Did the SBDC help you develop a Marketing plan?  

Government Contracting Assistance

Did the SBDC help you with government contracting  
 
If yes, how much in contracts was obtained?   
What was the outcome of your government contracting assistance?  
 

International Business Assistance

Did the SBDC help you with international business issues?  
 
If yes, how much have you had in International Sales since working with the SBDC?   
Was an international relationship developed?  
 

Environmental Management Assistance

Did you receive Environmental Management Assistance?  
 
What was the outcome of your EMAP assistance?
 

Engineering Development Assistance 

Did you receive engineering development assistance?  
 
What was the outcome of your engineering development assistance?  
 

Technology Commercialization Assistance

Did you receive technology commercialization assistance?  
 
Did you develop a SBIR/STTR proposal?  
 
How much SBIR/STTR financing was obtained?   
 
RELEASE: I grant permission for the Small Business Development Center (SBDC) and the U.S. Small Business Administration (SBA) and the Pennsylvania Department of Community and Economic Development (DCED) to use the information contained on this form for public information and promotion and educational purposes. I understand that this information will be shared with my state and federal legislators and may be used by the SBDC, SBA or DCED in promotional materials intended for public release. I further grant permission to the above groups to use photographs, audio and/or video of me, my business and its employees for public information and educational purposes.
I have read and understand the above stated terms and conditions. By means of an electronic signature I understand that I am agreeing to the terms and conditions.
Name   
Date