Please provide your contact information below. Contact information will not be shared externally of the NC Rural Center and NC Small Business Coalition.
* Company/Organization Name:
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Company/Organization Website (url):
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* What county is your company/organization based in? *(if not in NC, please respond with the county and state of your business)
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* Staff Contact First Name:
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* Staff Contact Last Name:
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* Email:
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Is your organization directly involved in the entrepreneurship and small business arena (i.e. resource provider, lending institution, technical support, etc.)?
If yes, please select the category (or categories) that best describes your organization's engagement with entrepreneurs and small business owners.
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Does your organization have a membership network?

Please provide your address information below. This information will be used to accurately identify your local, state, and federal policymakers regarding relevant small business legislation and engagement opportunities.
Address:
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City:
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State:
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Postal Code:
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Leading with diversity, equity, and inclusion is a core value of the NC Rural Center. The questions below are optional, but will help us better understand if we're meeting our commitment to building a more inclusive and equitable community.
Gender:
Race:
0/250
Are you of Hispanic/Latino/Spanish origin?

By submitting this form, I declare that I have the authority to commit to serving as an official NC Small Business Coalition Partner. As part of this Coalition, I acknowledge the NC Rural Center has permission to publicize my organization's name on their Coalition materials (e.g, website).
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