Welcome to the QEDC Client Intake Form. We use this form for a variety of programs, including consultations, StartUP!, MWBE, EAC, and more. This form asks you a variety of questions so we can better serve you. The form should take roughly 15 minutes to complete. Most fields are required, so please answer to the best of your ability. When you are done, click Submit to save your answers and complete the form. Click Save and then click Close if you want to save your answers and return at a later time to finish.
The Importance of Our Client Information Form!
QEDC offers free services to our clients. They are free because we receive funding from federal, state and city agencies. But they want to know who our clients are - in terms of client background, employment and business. This information is crucial if QEDC is to receive continued funding. It helps us to develop and expand programs that can be helpful to you.
We have developed a form that we believe is easy to fill out. Information is shared only with the funding agency and never with commercial entities.
By helping us we can continue to help you!
Please note that filling out this form does NOT make an appointment to meet with us. After filling out this form, you must contact us directly on this website to do so.
First Name
Middle Name
Last Name
Email Address