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SECTION 1: ATTENDEE INFORMATION

Attendee Name
Email

SECTION 2: IF A BUSINESS OWNER:

If you are not a business owner, skip to section 3
Business Address

SECTION 3: SUPPORT NEEDED

Are you still negatively impacted by the following: (Please check all that apply)
What type of small business assistance are you most interested in? (Check all that apply):
This Certification helps businesses get a 15% when bidding for County Contracts!

SECTION 4: IF BUSINESS OWNER, DEMOGRAPHIC DATA

(Optional, for grant and outreach purposes)
Owner identifies as:
(check all that apply)