Business Registration Questions |

Name(Required)

First Last

Email(Required)

Phone Number(Required)

Address(Required)

Street Address City State ZIP Code

Demographic Information

Sex(Required)

Different Term(Required)

Sexual Orientation(Required)

Different Term(Required)

Do you consider yourself transgender?(Required)

Race(Required)

Type of Asian:(Required)

Type of North African:(Required)

Type of Middle Eastern:(Required)

Type of Pacific Islander(Required)

Self-Describe Race(Required)

Highest Level of Education(Required)

Ethnicity(Required)

Military Status(Required)

What branch of the military?(Required)

Do you consider yourself a person with a disability?(Required)

Are you a dislocated worker?(Required)

A dislocated worker is someone who has lost their job through no fault of their own, typically due to circumstances like a plant closing, mass layoff, or a shift in the industry that makes their skills obsolete. They are generally eligible for unemployment benefits and unlikely to return to their previous industry or occupation.

How many people (including yourself) live in your household?(Required)

Please enter a number greater than or equal to 1.

What is your household income?(Required)

If your household has no income, please choose the "$0 to $15,000" option.

Birthdate(Required)

Employment Information

Employment Status(Required)

What is the name of your current employer? (If none, put "none." If self-employed, put "self-employed")(Required)

Most Recent Employment Start Date:(Required)

Most Recent Employment End Date (If Applicable):

If you left the job, what was the reason?

Regarding employment, please select:

Business Questions

This program is for people who are ready to register a new business. Are you ready to register one at your appointment?(Required)

What type of business will it be?(Required)

If you said "Other," please describe your industry(Required)

In 2 to 3 sentences, briefly describe your business(Required)

Do you have a business plan?(Required)

What will the business facility be?(Required)

How many owners will it have?(Required)

Please enter a number greater than or equal to 0.

What percentage of your business will be owned by a woman?(Required)

Please enter a number from 0 to 100.

What legal entity do you want for your business?(Required)

If you do not know, this program is not a good fit for you.

Will you conduct business online?(Required)

Do you understand that only the first 20 people to register a business will receive the $50 incentive?(Required)

Do you understand that you will have to pay all fees now and the $50 incentive will be provided after you complete your registration?(Required)

Do you have a debit or credit card that can pay for the business registration fee?(Required)

Do you have a debit or credit card that can pay for the business registration fee? A sole proprietorship costs $120. A corporation costs $135. An LLC costs $210 (later, for an LLC you will have to pay to have it published in multiple newspapers, which can cost around $700. You do not need this money for the appointment)

What name will your business have?(Required)

Business names in New York State are required to be unique. You can check to see what names corporations already have here: https://apps.dos.ny.gov/publicInquiry/

If your name is taken or somehow unusable, what is your first backup option?(Required)

What is your second backup option?(Required)

Dates and Times Available to Register Business(Required)

Please try to be as flexible as possible.

Final Questions

How did you hear about us?(Required)

If you selected "other," how did you hear about us?

If you found out about us from a website, please list the website

What type of help do you need for your business?(Required)

I agree to cooperate should I be selected to participate in surveys designed to evaluate SBA Resource Partner services. I permit SBA or its agent the use of my name and address for SBA surveys and information mailings regarding SBA products and services(Required)

By accepting this agreement I grant permission for QEDC to contact me regarding my business and its current status. I understand that any information disclosed will be held in strict confidence. (SBA will not provide your personal information to commercial entities.) I authorize SBA to furnish relevant information to the assigned management counselor(s). I further understand that the counselor(s) agrees not to: 1) recommend goods or services from sources in which he/she has an interest, and 2) accept fees or commissions developing from this counseling relationship. In consideration of the counselor(s) furnishing management or technical assistance, I waive all claims against SBA personnel, and that of its Resource Partners and host organizations, arising from this assistance. Please note: the estimated burden for completing this form is 5 minutes. You are not required to respond to any collection information unless it displaces a current valid OMB approval number. Comments on the burden should be sent to: U.S. Small Business Administration, 409 3rd Street, SW Washington DC 20416 and to: Desk Office SBA, Office of Management and Budget, New Executive Office Building, Room 10202, Washington D.C., 20503. OMB Approval (3245-0324). PLEASE DO NOT SEND TO OMB. Please mark """"yes"""" to verify that you agree to the terms above."(Required)

Yes

Would you like to be added to our newsletter to receive updates about future events?(Required)

Yes

Please certify that you have read and understood the above by writing your full name in the field here to serve as your electronic signature:(Required)

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