Business Registration Questionnaire Survey

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* 1. Please complete the following information:

Name of Business:

Business Owner Name:

Street Address, City, State, Zip Code:

Email Address:

Phone Number:

County:

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* 2. Which of the following demographic groups/categories do you identify with?
Select ALL that apply:

African-American

Subcontinent Asian

Asian-Pacific

Hispanic

Native-American

LGBTQ+

Persons with disability

Veteran

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* 3. Identified Gender

Male

Female

Non-Binary

Prefer not to answer

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* 4. Is this organization a storefront or a pop-up business?

Storefront (brick and mortar physical location)

Pop-up/ Online business

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* 5. How long have you been in business?

1-5 years

5-10 years

10-15 years

15+ years

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* 6. How many employees do you have in your business?

0-5 employees

5-15 employees

15-25 employees

25+ employees

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* 7. Which best describes your organization's industry?

Manufacturing

Higher Education

Financial Service

IT Services

Public Sector/Government

Food and Beverage

Mechanical/Engineering

Transportation

Retail and Consumer Goods

Telecommunication and Media

Electrical Industry

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* 8. "Diverse Ownership" is classified as a business owned by 51% or more ownership by women, minorities, persons with disabilities, veterans, or LGBTQ+ owners. Please indicate which of the following your company classifies as:

Women Owned Businesses

Minority Owned Businesses (Black American, Asian Pacific, Subcontinent Asian American, Hispanic American or Native American)

LGBTQ+ Owned Businesses

Person with Disability Owned Businesses

Veteran Owned Businesses

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* 9. What was your MAIN reason for starting/pursuing a business?

to bring new services to the market

to generate more income for personal use

to create a community need in my area

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* 10. What resources have you utilized to help start and/or grow your business? Select all that apply:

Family/Friends

Other Small Business Owners

Online Courses

Books

Community Organizations

Small Business Administration (SBA)

Small Business Development Centers (SBDC)

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* 11. How beneficial would a business accelerator program be in your community? (A business accelerator is a program that gives developing companies access to mentorship, technical resources, and other support that help them become stable, self-sufficient businesses. An accelerator will also connect companies to networks of peers whose experience they can learn from, and takes place in short- and long-term processes)

extremely beneficial

very beneficial

somewhat beneficial

slightly beneficial

not at all beneficial

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* 12. What barriers have you encountered with building your business? Check all that apply:

developing the idea

starting the business (documents, certification, etc.)

obtaining contracts

expanding the business (scaling product/service/employees)

building a supportive network of resources

accessing capital funding

minimizing expenses

hiring/retaining staff

hiring professional services (lawyers, accountants, etc.)

compliance (legal,tax,FDA,etc.)

retaining clients/customers

pricing

supply chain

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* 13. What areas would you like to learn more about regarding business expansion? Check all that apply:

Management and Consulting Services

Marketing and Communications

Government and Corporate Contract Opportunities

Business Certification Services

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* 14. Are you familiar with the Third-Party diverse business certifying agencies?

If not, would you find it beneficial?

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* 15. Have you or do you currently hold a diverse business certification?

If yes, please specify which certification

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* 16. How likely are you to obtain a diverse business certification if given the proper education/resources?

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* 17. Below are existing resources. In your opinion, how user-friendly are these tools:

	Very friendly	Somewhat friendly	Not user friendly	N/A (never used)
PA Business One-Stop Shop	PA Business One-Stop Shop Very friendly	PA Business One-Stop Shop Somewhat friendly	PA Business One-Stop Shop Not user friendly	PA Business One-Stop Shop N/A (never used)
PA Small Business Development Centers	PA Small Business Development Centers Very friendly	PA Small Business Development Centers Somewhat friendly	PA Small Business Development Centers Not user friendly	PA Small Business Development Centers N/A (never used)
PA DGS Small Business Self- Certification	PA DGS Small Business Self- Certification Very friendly	PA DGS Small Business Self- Certification Somewhat friendly	PA DGS Small Business Self- Certification Not user friendly	PA DGS Small Business Self- Certification N/A (never used)
National Minority Supplier Development Council (NMSDC)	National Minority Supplier Development Council (NMSDC) Very friendly	National Minority Supplier Development Council (NMSDC) Somewhat friendly	National Minority Supplier Development Council (NMSDC) Not user friendly	National Minority Supplier Development Council (NMSDC) N/A (never used)
Women's Business Enterprise National Council (WBENC)	Women's Business Enterprise National Council (WBENC) Very friendly	Women's Business Enterprise National Council (WBENC) Somewhat friendly	Women's Business Enterprise National Council (WBENC) Not user friendly	Women's Business Enterprise National Council (WBENC) N/A (never used)
National Gay and Lesbian Chamber of Commerce (NGLCC)	National Gay and Lesbian Chamber of Commerce (NGLCC) Very friendly	National Gay and Lesbian Chamber of Commerce (NGLCC) Somewhat friendly	National Gay and Lesbian Chamber of Commerce (NGLCC) Not user friendly	National Gay and Lesbian Chamber of Commerce (NGLCC) N/A (never used)
Pennsylvania Unified Certification Program (PA UCP)	Pennsylvania Unified Certification Program (PA UCP) Very friendly	Pennsylvania Unified Certification Program (PA UCP) Somewhat friendly	Pennsylvania Unified Certification Program (PA UCP) Not user friendly	Pennsylvania Unified Certification Program (PA UCP) N/A (never used)
Small Business Administration 8(a) Program-SBA 8(a)	Small Business Administration 8(a) Program-SBA 8(a) Very friendly	Small Business Administration 8(a) Program-SBA 8(a) Somewhat friendly	Small Business Administration 8(a) Program-SBA 8(a) Not user friendly	Small Business Administration 8(a) Program-SBA 8(a) N/A (never used)
Vets First	Vets First Very friendly	Vets First Somewhat friendly	Vets First Not user friendly	Vets First N/A (never used)
Disability IN	Disability IN Very friendly	Disability IN Somewhat friendly	Disability IN Not user friendly	Disability IN N/A (never used)

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* 18. During the past 5 years, has your company submitted a bid, quote, or received an award for any part of a contract with a government/corporate entity?

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* 19. Are you interested in having a free consultation with the Wilkes-Barre Connect team to get connected with additional business growth resources, such as: business plan assistance, financing/capital, workforce solutions, marketing/sales, city permits/licensing, real estate, estate planning, intellectual property management, internship programs, entrepreneurial mindset and exploration, and networking?

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* 20. Will you need translation/interpreting services at the event? If so, what language?

If yes, please select language:

Business Registration Questionnaire

Question Title

* 1. Please complete the following information:

Question Title

* 2. Which of the following demographic groups/categories do you identify with?Select ALL that apply:

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* 3. Identified Gender

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* 4. Is this organization a storefront or a pop-up business?

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* 5. How long have you been in business?

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* 6. How many employees do you have in your business?

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* 7. Which best describes your organization's industry?

Question Title

* 8. "Diverse Ownership" is classified as a business owned by 51% or more ownership by women, minorities, persons with disabilities, veterans, or LGBTQ+ owners. Please indicate which of the following your company classifies as:

Question Title

* 9. What was your MAIN reason for starting/pursuing a business?

Question Title

* 10. What resources have you utilized to help start and/or grow your business? Select all that apply:

Question Title

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* 12. What barriers have you encountered with building your business? Check all that apply:

Question Title

* 13. What areas would you like to learn more about regarding business expansion? Check all that apply:

Question Title

* 14. Are you familiar with the Third-Party diverse business certifying agencies?

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* 15. Have you or do you currently hold a diverse business certification?

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* 16. How likely are you to obtain a diverse business certification if given the proper education/resources?

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* 17. Below are existing resources. In your opinion, how user-friendly are these tools:

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* 18. During the past 5 years, has your company submitted a bid, quote, or received an award for any part of a contract with a government/corporate entity?

Question Title

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* 20. Will you need translation/interpreting services at the event? If so, what language?

* 2. Which of the following demographic groups/categories do you identify with?
Select ALL that apply: