SMALL BUSINESS MANAGEMENT PROGRAM
APPLICATION FORM
Small Business Development Center
Central Oregon Community College
Physical address: 1027 NW Trenton, Bend OR 97701
Mailing address: 2600 NW College Way, Bend, OR 97701
Phone: (541) 383-7290 Fax: (541) 383-7503 Email: sbdc@cocc.edu
Name: ____________________________________________________________________________________
Business Name: _____________________________________________________________________________
Business Location: ___________________________________________________________________________
Business Mailing Address: _____________________________________________________________________
Work Phone: ____________________ Cell/Other Phone: ____________________ Fax: ___________________
Email: ______________________________ Business Web Site Address: ______________________________
Type of Business: __________________________________________ Number of Employees: ______________
Briefly describe your core business: _____________________________________________________________
__________________________________________________________________________________________
Years in business: _____________________ Years of formal academic training: _________________________
Years of training for your particular field: __________________________________________________________
What accounting software do you use? ___________________________________________________________
Can you produce accurate monthly financial statements? ____________________________________________
Are there other people in your business that are considering attending classes? If so, who? _________________
__________________________________________________________________________________________
Optional information that you would like us to know about you: ________________________________________
__________________________________________________________________________________________
What would you like to learn through participation in this program? _____________________________________
__________________________________________________________________________________________
When is the best time to call to set up an interview? _________________________________________________
Current Year Sales Range: ____Under $250,000 ____$250,000 - $999,999
____$1,000,000 - $4,999,999 ____$5,000,000 - $9,999,999
____$10,000,000+
Prior Year Sales Range: ____Under $250,000 ____$250,000 - $999,999
____$1,000,000 - $4,999,999 ____$5,000,000 - $9,999,999
____$10,000,000+
2
nd
Prior Year Sales Range: ____Under $250,000 ____$250,000 - $999,999
____$1,000,000 - $4,999,999 ____$5,000,000 - $9,999,999
____$10,000,000+
Please see next page
50 HOURS
OF INSTRUCTION AND COUNSELING FOR $999!
HOW DO WE DO IT?
Participants in this program receive instruction and counseling from an experienced professional that will prove to be
worth many times what we charge in tuition. With the support of Central Oregon Community College and our
partners, the Oregon Business Development Department and the US Small Business Administration, the Small
Business Development Center offers this program in the belief that you and your business are a good investment of
the dollars required to subsidize this program. Because we believe in you and the value of a strong small business
sector we are willing to bet on your successful growth.
SCOPE OF WORK AGREEMENT
This letter of understanding defines the obligations of the Business Advisor and the Client and the scope of work for
the services being provided by the Small Business Development Center. It is anticipated that the Client will spend at
least 50 hours attending classes, counseling sessions and working on the management of their business.
The Client agrees to:
1. Attend relevant scheduled classes.
2. Set aside time each month for counseling sessions.
3. Work on business improvement projects to achieve business goals.
4. Keep an open mind about new business concepts and implement these when appropriate.
5. Promptly pay any fees associated with classes.
6. Establish annual goals,
7. Set schedule to work on meeting goals.
8. Continually assess progress towards meeting goals.
9. Provide year-end financial impact data.
10. Continually provide current financial information.
The Business Advisor agrees to:
1. Coordinate and conduct scheduled classes to provide resources and concepts.
2. Set aside time each month for counseling sessions.
3. Be available by phone, email and fax.
4. Be proactive by constantly searching for information relevant to the client.
5. Assist client in exploring alternative solutions to business problems.
6. Continuously strive to remain “state-of-the-art” on business concepts.
7. Be supportive, respectful, non-judgmental, prompt and offer an outside perspective.
Please sign below:
_________________________________ ___________________________________
Business Advisor Date Business Owner* Date
*My signature here also indicates acceptance that my business
name may be used in future promotions for the SBM program
or other Small Business Development Center activities.
Funded in part through a Cooperative Agreement with the U.S. Small Business Administration.
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