Are you a Durham County Resident? *

Yes

THIS PROGRAM IS ONLY OPEN TO DURHAM COUNTY RESIDENTS. IF YOU ARE NOT A DURHAM COUNTY RESIDENT, PLEASE EMAIL US FOR INFORMATION ON A PROGRAM THAT YOU CAN QUALIFY FOR.

Last Name *

Business Name

Email *

Phone *

Website

Business Address

City *

State

Postal code

First Name *

Business Legal Structure

Sole Proprietorship
Limited Liability Company (LLC)
C-Corporation
S-Corporation
Partnership
Non-Profit
Government Agency
Educational Institution
Financial Institution
Not formed yet
Other
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Business Status

Not Started
Business Started but No revenue generated
Business Started & revenue generated less than 3 years
Business Started & Operations 3-5 years
Business Started & Operational for 6-10 years
Business Started & Operational 11-20 years
Business Operational over 20+ years
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Client Demographic Information.

Demographic information should be provided for primary business owner and anyone who owns 20% or more in the company. This information is important for the business certification counseling.

Is your business majority owned (51% or greater) by one of the following? (Select all that apply) *

Woman-Owned

Minority-Owned

Veteran-Owned

Disabled-Owned

Small Business-Owned (Less than 100 employees)

If Minority, please select: *

American Indians (including Alaska Natives, Eskimos, and Aleuts)

Asian Americans

Native Hawaiians and other Pacific Islanders

Black American

Hispanic American

Company Services

Participant Consent

I request business certification counseling services from Infinity Bridges, a program in partnership with Durham County. I agree to cooperate should I be selected to participate in surveys designated to evaluated business certification services. I understand that any information disclosed will be held in strict confidence. Please check the box below to confirm you have read and understand the terms of the program participation.

Participant Consent confirmation *

I have read the participant description above and understand the terms of participation.

I agree to receive marketing and information messaging from INFINITY BRIDGES at the phone number provided above. I understand I will receive approximately 2 messages a month, data rates may apply, reply STOP to opt out.I agree to TERMS OF USE and the PRIVACY POLICY provided by the company.