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2. 
3. Durham Small Business Directory
5. Business Name
7. Business Owner's First Name
8. Business Owner's Last Name
10. Other Business Owner First Name
    If Applicable
11. Other Business Owner Last Name
13. Primary Phone Number
15. Email Address
19. About Your Business
21. How Many Full-Time Employees Do You Have?
    -- Select One --01-56-1011-2021-5051-99100-499500-9991000-4999
23. How Many Part-Time Employees Do You Have?
    -- Select One --01-56-1011-2021-5051-99100-499500-9991000-4999
25. Is more than half (at least 51%) of this business owned by women?

    1. Yes
    2. No
27. Is more than half (at least 51%) of this business owned by members of a racial minority?

    1. Yes
    2. No
29. If yes, please specify:

    Check all that apply.

    1. American Indian or Alaskan Native
    2. Asian
    3. Black or African American

    1. Native Hawaiian or Other Pacific Islander
    2. Hispanic, Latino, or Spanish
    3. Other
31. If Other, Please Specify:
33. If Hispanic, Latino, or Spanish, please specify:

    Check all that apply.

    1. Mexican, Mexican American or Chicano
    2. Puerto Rican
    3. Cuban
    4. Other Hispanic, Latino or Spanish origin
34. If other Hispanic, Latino or Spanish origin, please specify:
36. In what year was your business originally established?
38. How is your business structured?
    -- Select One --Sole proprietorshipLLCC CorporationS CorporationGeneral PartnershipLLPOther
39. If other, please specify:
41. Which of the following best describes your business' sector?
    -- Select One --Agriculture, Forestry, Fishing, and HuntingMiningUtilitiesConstructionCommunicationsManufacturingWholesale TradeRetail TradeTransportation and WarehousingInformationFinance and InsuranceReal Estate and Rental LeasingProfessional, Scientific, and Technical ServicesManagement of Companies and EnterprisesAdministrative, Support, Waste Management, Remediation ServicesEducational ServicesHealth Care and Social AssistanceArts, Entertainment, and RecreationAccommodation and Food ServicesPublic AdministrationOther
42. If Other, please specify:
44. What does your business need most support with? Examples: networking, technical assistance, marketing, capital readiness, bidding on government contracts.
46. By completing this form, you agree to be included in the City of Durham's Business Directory. Your information will remain confidential to the City of Durham. Your contact information may be used by the City's Office of Economic and Workforce Development to reach out to you in relation to business opportunities.
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48. 1. Receive an email copy of this form.
49. Email address

    This field is not part of the form submission.

50. Submit

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