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+
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