HTML Preview Business Intake Form page number 1.
BUSINESS INTAKE FORM
Business Name:
Website:
Primary Contact Name (First Last):
Cell Phone:
Daytime Phone:
Cell Phone:
Daytime Phone:
Email:
Email:
Secondary Contact Name (First Last):
Is your business currently operating at a physical location?
Yes No
If yes, date opened:
Current Business Address:
Proposed Delray Beach Address:
How many employees do you currently have?
Full-time: Part-time:
None
If yes, within what time period?
No
Yes
Are you planning to add employees?
Full-time jobs to be added: Part-time jobs to be added:
RentOwnDo you rent or own the proposed Delray Beach business location?
Under Contract to Own
Anticipated Closing Date:
Monthly Rental Rate: Lease Term:
Negotiating Lease
Not Secured
What is the square footage of your business location (current or desired)?
Submit by Email
Print Form