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Small Business Technical Assistance Intake Form

Please fill out this form completely and accurately as the grant funding needed to provide support depends, in part, upon collecting this information. If you have any questions please email Giulia at

Owner Information

Demographic Information: we are required to collect the following information for purposes of anonymous data reporting. This information will not be used for a discriminatory purposes. If you have questions or would like to change this information in the future please contact Giulia at


If different from mailing address.
Please select the option that best describes your household size and gross annual income amount. Your gross annual income is required data needed to fund our CDCSB Small Business Program. Your data is only shared for reporting purposes and we prioritize our clients’ confidentiality.

Business Information

For example: restaurant, pet groomer, acupuncture, etc.
Check all that apply:

Check all that apply:

If you selected more than one category above please prioritize what type of help would be most beneficial.

I understand that the information given in this application will be used to determine eligibility for services provided by the Community Development Corporation of 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 of the business or prospective business receiving technical assistance. My agreement affirms that I will not hold the Community Development Corporation of 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 72 hours notice.