Small Business Development
Frequently Asked Questions
Access To Capital
Business and Marketing Plans Development
Community Development Projects
Frequently Asked Questions
Business Startup Bootcamp Registration DRAFT
Date Of Birth*
American Indian/Alaskan Native
Black (Not Hispanic)
White (Not Hispanic)
Less than high school
High School Diploma/GED
Full Time Employed
Full Time Self-Employed
Unemployed less than 6 months
Unemployed more than 6 months
Annual Income in 2016*
Name of Business
Type of business
Business Start Date
Limited Liability Company
Please check ONE of the business registration documentation held by your business
L.A. Tax Registration Cert. (Business License)
Seller's Permit/Resale Number
Certified Minority-Owned Business
Completed Business Plan
Federal Tax ID
Please provide notes to clarify the options selected above (i.e. date obtained, etc.)
Please also indicate any previous management/work experience.*
If office/storefront, please type in your business address
Are you operating this business full or part time?
Have not started
How many employees are currently, or will be, working for your business?* (including yourself)
6 or more
Are you seeking to hire additional employees?
Are you planning a business closure?
Are you planning to lay off employees?
If yes to any or both of the previous two questions: How many employees are threatened by layoff/closure?
Please indicate your current monthly revenue (gross receipts)
Please indicate your annual Revenue (gross receipts) for 2015
Have you ever started/owned another business?
If yes, is it still operating?
Please describe the business and explain if it is no longer in business:
Are you in need of any of these assistance?*
Access To Capital/Loan Packaging
Other business need
List any other fields you might need assistance in
Business Startup Bootcamp Assesment Questions
Tell us about yourself*
Educational Background/Work & Business-related Experience*:
The training requires basic computer skills to complete assignments. Please describe your computer skills*:
Give a description of your business or business idea*:
How soon do you plan to launch or relaunch your business?
Where do you see your business in 3 years?*
What are three outcomes you expect from this training?
Have you participated in any other business training programs? If so, when and where?
Describe a challenging situation you have faced recently and how you overcame it?
How did you hear about this program?
Please specify the answer of the previous question
(e.g. if you were referred by the Worksource please specify which one)
Terms and Conditions*
By clicking here, I certify that all my answers above are true and correct to the best of my knowledge.
I also agree that by accepting to receive assistance from the BusinessSource Center I will cooperate and provide the BusinessSource staff with all requested information and documents to verify the outcomes reported in compliance with CFR 570.506(b)(5) and (6).
* is a required field.
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8248 Van Nuys Blvd,
Panorama City, CA 91402
(In between CVS and T-Mobile)
Ph: (818) 894-8800
Fax: (818) 894-8810
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