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SBCA's Certification Assessment

Rather than wasting your valuable time, SBCA has come up with a way to insure what certification is right for you. The process of becoming certified can be very complicated or even down right impossible. At the current time, over 80% of the applications for 8(a) are returned.

SBCA has designed this assessment to enable us to best determine your chances of becoming certified as a Small, Minority, Women-owned, Disadvantaged or Service Disabled Veteran Business Owned-Small Business Concern.

**Required Fields in Bold**
Business Name
Street Address
City
State
Zip
Business Phone
Contact Person
Fax Number
Email
Web Site
   
Is the business address/phone # the same as residence?
yes no

If yes, explain why you work from home:
 
Controlling interest in the business:
Male Female
Controlling interest in the business is by (please check all that apply).

Minority Non- Minority Disabled Veteran.
Is the person applying for certification a US citizen? yes no
How long have you been in business?
What form of business have you established:

How much money did you need to start your business?
Where did the money come from:
checking, savings other

if other, please explain
What is the nature of your business?
Does your type of work require any licenses, permits, or degrees?

yes no

if yes, what type?
Partnerships and Corporations please provide the following information for any partners or shareholders of your company

Total number of shareholders:
Partner or Shareholder name

male female

Ethnicity
Ownership Percentage


Partner #2, name

male female

Ethnicity

Ownership Percentage
Is the business owned in full or part by another company?
yes no
For Corporations name of the company Officers

President's Name

Ethnicity

Date Elected/Appointed
Vice President's Name

Ethnicity

Date Elected/Appointed
Secretary's Name

Ethnicity

Date Elected/Appointed
Treasure's Name

Ethnicity

Date Elected/Appointed
List the names of the current Board of Directors that are not stockholders.

Total # of Board of Directors

Name

Ethnicity
Name

Ethnicity
List any major equipment your company owns.
equipment#1

Owned Leased
equipment#2

Owned Leased
equipment#3
Owned Leased
equipment#4
Owned Leased
Have you ever been denied certification by any government agency?
yes no

If Yes, explain
Have any other Individuals in your company been denied certification?
yes no

If Yes, explain
What geographical area do you serve?

How did you hear about certification?

Why do you want to get certified?

How did you hear about SBCA?

Are you in a HUB Zone?
yes no
Comments
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Small Business Consulting Agency
310 N. Indian Hill Blvd., Suite 305
Claremont, CA 91711
Certification Division: 909-418-4452
GSA Schedule Division: 714-222-2847
Info@1SBCA.com

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