Business Needs Assessment

Let Us Help You

Carolina Small Business offers a variety of financing, counseling, and technical assistance services to aspiring and current entrepreneurs. After you complete the form, our team of experts will assess your submission and reach out to see how we can best help. This form will take about 10 minutes to complete.

Have you been in contact with a staff member from Carolina Small Business?

YESNO

Staff Member Name: Please select their name below. If the name of the staff member you've been in touch with is not listed below, just leave this field blank.

UserId

BSO Email

How did you hear about us?

Who may we thank for your referral to our organization?

Please indicate the specific person or organization that referred you.

Contact Information

First Name

Last Name

Email

Preferred Language

EnglishSpanishOther

Demographic Information

We request that you provide the below demographic data to learn more about the needs of small business owners. You may select "Decline to State" for any question. Federal law forbids discrimination on the basis of the below information, including whether you choose to furnish it. If you choose to not furnish this information, we note gender, race, and ethnicity on the basis of visual observation or surname. For more information about the demographic terms below, please see our website.

Sex/Gender

Race

Ethnicity

Veteran Status

Disabled

LGBTQ+ Affiliation

Business Characteristics

Business Legal Name

Doing Business As (dba):

Business Phone

Employer Identification Number (EIN)

Please enter exactly 9-digits without dashes or special characters

*If you do not have an employer identification number because the small busines is a sole proprietorship, enter the primary business owners social security number or tax identification number. Remember, all information you provide is confidential and securely stored. We will not use this information for any reason except ensure your records are properly matched in our internal databases.

Business Address

*Please indicate the location where business activities take place, do not enter a PO Box.

Shipping Street

Shipping address may not be a post office box.

Shipping City

Shipping State

County

Shipping Zip Code

How many individuals are employed at the small business entity, if any, as of today's date?

Total should be between 0 - 99 employees. Select "0" if you have no employees based on the below definition: Include all individuals receiving payroll compensation from the business.  Count the owner(s), if they receive any compensation from the operation of the business. Do not count any contract positions.

What is the primary sector of activity of the business?

Search by NAICS number or industry keyword

NAICS 6-Digit

SFDC NAICS Id

Assessment Questions

Thinking about the next year, what do you think will be the small business entity's biggest challenge?

Revenue declines from lack of customersInability to plan for the future due to uncertaintyBeing able to source needed materials from vendorsAbility to attract and retain qualified staffOtherNone of the Above

Other: write-in:

Please write-in your biggest perceived challenge for the upcoming year.

In the past 2 years, has the business entity had any challenges related to paying its obligations in a timely manner?

YesNo

What is the primary reason that caused you to be unable to meet these obligations?

Does the small business entity currently have open and/or carry balances on any of the below credit products?

What parties are primarily responsible for the creation of the small business's financial statements?

Business Owner(s)Staff Member(s)Contractors/External Vendor(s)/CPA

Does the small business currently utilize, or do you have a desire to learn about, any of the below skills and associated software?

Customer/Business Data Management

Marketing and Social Media

Business and Financial Management

Other

	Currently Utilize, Want to Learn More	Don't Currently Utilize, Want to Learn More	No Interest
Soft Skills Management

How have your business operations been affected by the coronavirus (COVID-19) pandemic?

Not affectedSlightly affectedModerately affectedStrongly affected

Please indicate what types of financial assistance the small business has applied for, if any, within the last 12 months.

Applied for assistance that requires repayment from...

Are you interested in learning about our loan products and services to assist your business?

YesNo

	Open, Paid in Full Monthly	Open, Pay Minimums Only	Open, Pay More than Minimums	Don't Have This Product
Credit Card(s)
Line(s) of Credit
Term Loan

	Open, Paid in Full Monthly	Open, Pay Minimums Only	Open, Pay More than Minimums	Don't Have This Product
Credit Card(s)
Line(s) of Credit
Term Loan

	Approved	Declined	Did Not Apply
Private Industry Grant
Government Grant

	Approved	Declined	Did Not Apply
NC Rapid Recovery Loan
SBA Economic Injury Disaster Loan (EIDL)
SBA Paycheck Protection Program (PPP)
Other Loan Program

	Currently Utilize, Want to Learn More	Don't Currently Utilize, Want to Learn More	No Interest
Social Media
Marketing Strategy Creation/Revision
Search Engine Optimization

	Currently Utilize, Want to Learn More	Don't Currently Utilize, Want to Learn More	No Interest
Accounting and Financials
Access to Capital
Disaster Recovery / Resilience