Register For Business Advising

Hawai‘i SBDC, East Hawai‘i Center

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For all of the following questions, please answer regarding the business venture for which you seek assistance.

First Name
Last Name
Zip Code	Enter your 5 digit Zip Code. If you don't have one or don't know your zip code, enter 00000

Business Name	Leave blank if you do not have a name chosen or the business name is the same as your name.
Position	Your position or title related to this business
Address	Your physical street address (number and street) of the business. If a home based business, or the business has not started yet, use your home address.
Address Line 2	Optional. Use if you need additional address postal information like apt, floor, suite, etc., or a PO box.
City
State

Please enter contact information regarding this business so that we may contact you if necessary

Primary Phone	The best phone number (with area code) to reach you during our standard business hours. Include extension if necessary.
Primary Phone Type	Type of the primary phone above
Secondary Phone	A secondary phone number to contact you, if we cannot reach you at the primary number.
Secondary Phone Type	Type of the secondary phone above

Web Site	Web site URL for the business

Please answer the following demographic questions about yourself.

Race	Asian Black or African American North African Middle Eastern Native American/Alaska Native Native Hawaiian/Pacific Islander White Prefer not to say Other Check any that apply
Hispanic Ethnicity
Gender
LGBTQ
Person with Disability	Do you consider yourself a person with a disability
Military Status
Branch of Service

Please help us understand your business or business idea.

Briefly describe this business or business idea

Brief three to five word description of the business

Do you have a Written Business Plan?

Target market analysis
Competitor-competition analysis
Business management and personnel
Financial management
Suppliers
Equipment requirements
Business process description
Physical space
Start-up cash requirements
Utilities
Cash pro forma
Exit strategy

Is this your first business venture?

Do you have a separate business checking account?

Have you received business consulting from other public sources and if so, whom?

Is this a Non Profit Venture?

Yes

Business Status

Business has started

Check if you have started conducting business. Leave unchecked if you are in the planning stages and have yet to start this business.

Check all that apply:
Business is Now Open and Operating
a. Acquired State of Hawai'i General Excise Tax Number
b. Completed a documented transaction for the sale of a product, or professional service, or personal service for the purpose of gain or profit
c. Contracted for or compensated an employee or independent contractor to perform essential business functions
d. Acquired debt or equity capital to pursue business operations, e.g. to purchase inventory, equipment, building, business, etc.
e. Incurred business expenses in the operation of the business.

Year Started	Year this business started based on first business action a to e above
Month Started	Month this business started based on first business action a to e above
Business Type	Primary category of business
Female Ownership %	% Enter the percent female ownership for this business.
Business Online	Yes If business is conducted online
Home Based Business	Yes If business is home based
8(a) Certified	Yes If you are currently 8(a) certified.

Business Organization

Legal entity of the business

Employees FT

Current Number of Full Time Employees

Employees PT

Current Number of Part Time Employees

Annual Sales $

Annual Sales $ for the most recent full business year

Annual P/L $

Annual Profit/Loss $ for the most recent full business year

Do you have financial statements for this business?

Balance Sheet
Profit and Loss
Cash Flow

Are you currently exporting

Yes

Export Employees	Current Number of Total Export Related Employees
Export Sales $	Export Related Sales for most recent full business year
Export Countries	Countries you are currently exporting to. Start typing the name of the country and a list will appear to choose from. You may select more than one.

How did you hear about us?
If you selected Lender above, which Lender?	Choose the Lender, if referred by a Lender.
Details for how you heard about us	Briefly describe the person or resource name of how you heard about our services.
Assistance Requested	Business Accounting/Budget/Tax Business Growth Business Plan/Strategy Buy/Sell a Business Cash Flow Management Customer Relations Financing/Capital Franchising Government Contracting Government Financing Human Resources/Employees International Trade Legal Issues Managing Business Marketing/Sales Online Business/eCommerce Start-up Assistance Technology Check all the kinds of assistance that you seek
Briefly describe the specific assistance you are requesting
Briefly describe what you want consulting with us to accomplish

Expectations Agreement

The Hawai'i Small Business Development Center (Hawai'i SBDC) provides business advisory services at no cost to small business owners and those who wish to start a business. Our mission is to support the economic well-being of our communities and of the State of Hawai'i through assisting small businesses in achieving and maintaining sustainable growth.

In order for us to continually improve the quality of our service to the business community, we require your cooperation in providing information regarding the success of your company. We will ask for the information at the start of our relationship, and again at an interval coinciding with our funding year.

The first set of data that you provide is a starting point. You will receive a brief survey from the Hawaiʻi SBDC shortly after your first advising session. The second survey from the Hawaiʻi SBDC will be conducted after the close of the calendar year to provide a direct measure of your satisfaction level and our effectiveness at that time.

A National Survey is conducted by a third party (usually in the May to June timeframe) to independently ask for your view about Hawai'i SBDC services. This survey includes questions of sustainability (business growth and survival) as well as long-term effects of our services.

We may ask you to verify by way of signing a Client Impact Form that our efforts have helped you to achieve certain results, such as starting a business, receiving capital, adding or retaining jobs and increasing sales revenue.

All information gathered is kept strictly confidential within the Hawai'i SBDC and will not be released to any third party except in aggregated form.

Aggregated form means added together with other clients’ data without respect to the identity of any client. Our use of the data you provide is in statistical analyses internal to our organization and to our funding partners to prove the effectiveness of their support of our program.

Advising occurs in "sessions." Arising from those sessions, you, the client, can expect tasks to be agreed upon which are to be completed prior to the next session. Successful outcomes depend on both the advisor and client being prepared at the beginning of each session.

Advisor Affirmations

I will provide thorough and focused attention to this client's enterprise, using all appropriate resources available to the Hawai'i SBDC.
To the best of my ability, I will be prepared for each session.
If I cannot keep an appointment for the session, I will let the client know at least 24 hours in advance.

Client Affirmations

I will support the Hawai'i SBDC by providing the requested information about my business.
To the best of my ability, I will be prepared for each session.
If I cannot keep an appointment for the session, I will let the center know at least 24 hours in advance

Expectations Agreement

I agree to the above Hawai'i Small Business Development Center Client Expectations.

Please read the following, enter your Full Name, and click Continue below to indicate your acceptance.

I request business counseling service from the Small Business Administration (SBA) or an SBA Resource Partner. I agree to cooperate should I be selected to participate in surveys designed to evaluate SBA 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

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.

I self-certify that neither I nor my company are currently in suspension or debarment by a Federal Agency.

Please enter your full name, indicating your acceptance of the above terms.

Full Name:

Date: 12/6/2023 12:31:24 AM

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Register For Business Advising

Hawai‘i SBDC, East Hawai‘i Center

Please read the following, enter your Full Name, and click Continue below to indicate your acceptance.

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