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SBTA Assessment of Needs

Please fill out this assessment of needs completely and accurately as the grant funding needed to provide support depends, in part, upon collecting this information. Filling out this assessment of needs does not garantee admission to this program.

If you have any questions please email Giulia at giulia@cdcsb.org.

 

Disclosures: CDCSB will follow strict rules to protect your confidentiality.  The personal data collected below including name, street address, email address and any other personally identifiable information is protected by the Data Privacy Act. You will never be named in any reports.  Your responses may be looked at individually by the funding source, or contractors hired by the funding source to collect and analyze data, and your name or street address will not be reported.  Income, city, state, zip code, family size, and other demographic data will be reported.



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Business Information





For example: restaurant, pet groomer, acupuncture, etc.

Check all that apply:





(You will need to set some time aside during the week to work with your consultant and/or work on the homework that was assigned to you)


Demographic Information

(check all that apply)


I understand that the information given in this application will be used to determine eligibility for services provided by the Community Development Corporation South Berkshire Small Business Technical Assistance Program and will be treated as confidential. The information provided in this application has been given freely and is true to the best of my knowledge. I affirm that I am the owner or manager of the business or prospective business receiving technical assistance. My agreement affirms that I will not hold the Community Development Corporation South Berkshire, or its representatives, liable for business outcomes based on counseling, training, or teaching I receive. I understand that if accepted into the program I will make any scheduling changes with at least 24 hours notice. I give my permission to the CDCSB to use my name, the name of my business/organization, and/or my picture or a picture of my business or organization for the purpose of promoting their programs, reporting on their programs, or securing additional funds for their program.

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