The GLAAACC Way

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*Name

*Title

*Name of Firm

*Type of Business

*Years in Business

*Number of Employees

*Business License held

*EIN Number

*NAICS Code

*Description

*Company Address

*City

*State

*Zip

*Email

*Phone

*Website

*2023 Revenue

*Certification

DBE     MBE     WBE     DVBE     SBE    

*Other

*Description of Business

*Are you a member of any special interest groups/organizations?

*How did You Hear About Us?

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*Please UPLOAD your capabilities Statement (Min of three pages) or Business Plan in a .pdf document

*Submitting this application online, means that I am committed to fully participate and attend all of the virtual Business Evolution (BEP) Classes

*Date

Fields with (*) are compulsory.