RCAC PTAC Client Intake Question Title * 1. Company Information Company Name Contact Person Physical Address City State Zip County Question Title * 2. Mailing Address (if different from physical address above) Mailing Address City State Zip County Question Title * 3. Contact Information Phone Fax Email URL (if applicable) Question Title * 4. Type of Business (i.e., construction, printing, janitorial, manufacturer, etc.) Question Title * 5. Ownership/Size (check all that apply) Individual Large Business Government Not-for-Profit Small Business 8(a) SDB Veteran-Owned Service-Disabled Veteran-Owned HUBZone Certified DBE Certified WBE Certified Woman-Owned Minority-Owned Located in a HUBZone Question Title * 6. Which RCAC services are you specifically requesting? Check all that apply. Bid Leads Proposal or Bid Development Marketing Assistance Webinars System for Award Management (SAM) Assistance Contracting Policies/Regulations Small Business Certifications Veterans' Verification Procurement News Other (please specify) Question Title * 7. Upon completion and submission of this form, you are expressing a specific and explicit interest in receiving the client service(s) selected above. Date Date Question Title * 8. Thank you for helping us fulfill our documentation requirements. An RCAC Counselor will contact you shortly to address your specific concerns. Please leave additional comments below: Done