Register For Counseling
Piedmont Community College Small Business Center
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Leave blank if you do not have a name chosen or the business name is the same as your name.
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Your position or title related to this business
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Your physical street address (number and street) of the business. If a home based business, or the business has not started yet, use your home address.
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Optional. Use if you need additional address postal information like apt, floor, suite, etc., or a PO box.
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Check if you have started conducting business. Leave unchecked if you are in the planning stages and have yet to start this business.
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Legal entity of the business
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Current Number of Full Time Employees
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Current Number of Part Time Employees
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Annual Sales $ for the most recent full business year
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Annual Profit/Loss $ for the most recent full business year
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Current Number of Total Export Related Employees
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Export Related Sales for most recent full business year
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Please read the following, enter your Full Name, and click Continue below to indicate your acceptance.
I request business counseling services from the Small Business Center Network (SBCN) through one of its directors or resource partners, and I agree to cooperate should I be selected to participate in surveys designed to evaluate these services. I permit the SBCN and its agents the use of my name and address for SBCN surveys and information mailings regarding SBCN products and services.
I authorize the SBCN to furnish relevant information to the assigned counselor(s).
I understand that any information disclosed will be held in strict confidence and that the SBCN will not provide my personal information to commercial entities. I further understand that the SBCN counselor(s) agrees not to: 1) recommend goods or services from sources in which he/she has an interest, or 2) accept fees or commissions developing from this counseling relationship. In consideration of the counselor(s) furnishing business startup, management or technical assistance, I waive all claims against SBCN personnel, its resource partners and host organizations.
By entering my full name here, I indicate my acceptance of the above terms.
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