Business Providers - Austin Area Urban League

I request business counseling service from the Small Business Administration (SBA) or Community Navigator. I agreed to cooperate should I be selected to participate in surveys designated 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.

Yes No

Client signature (type full name)

Client signature date (mm/dd/yyyy)

Client email address (enter none@none.com if unknown) *

Client business street address (use client home street address, if not in business yet)

Client business zipcode (use client home zipcode, if not in business yet)

Client Race

Client gender identity

Male Female Nonbinary

Client disability status

Not disabled Disabled

Client identifies as a member of the LGBTQ+ (lesbian, gay, bisexual, transgender, questioning) community?

Yes No

Client identify as

Client military status

Client ethnicity

Hispanic or Latinx Non-Hispanic or Non-Latinx

Client in business

Yes No

Client's EIN number (Taxpayer ID) - Do not enter social security number

Client legal structure

Client full-time employees

Client part-time employees

Enter the 6-digit code from the list below or use this lookup tool
Accommodation & Food Services 722511
Administrative & Support 561110
Agriculture 111419
Arts 711190
Construction 238990
Educational Services 611710
Entertainment & Recreation 713990
Finance & Insurance 523999
Fishing 114119
Forestry 113310
Health Care & Social Assistance 621399
Information 519290
Management of Companies & Enterprises 551114
Manufacturing 339999
Mining 212390
Professional, Scientific & Technical Services 541990
Public Administration 921190
Real Estate, Rental, & Leasing 531210
Retail Trade 459999
Transportation & Warehousing 485999
Utilities 221320
Waste Management & Remediation Services 562920
Wholesale 424990
Other Services (except Public Administration) 813990

Has the client applied for or received any SBA services in the last 5 years? If so, which?

Does the client conduct business in a language other than English

Yes No

Is the business majority woman-owned
A business is woman-owned if at least 51% of the business or stock is owned by one or more women and the management and daily business operations are controlled by one or more women.

Yes No

SBA CNPP: AAUL Client Intake

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