Inquiry Form

Please complete the form below and we will be in touch with you shortly to discuss your needs.

* = Required Field

Facility/Program Name: *
Company Name: *
Primary Contact:
First Name: *
Last Name: *
Secondary Contact (if any):
First Name:
Last Name:
Company Type: *
Address 1: *
Address 2:
City: *
State: *
Zip/Postal Code: *
Phone Number: *
Cell Phone Number:
Fax Number:
Email: *
Website Address:
Product & Service Description: *
Gender: *
Race / Ethnicity:
Asian/Pacific Islander
American Indian/Alaskan Native
Native Hawaiian/Other Pacific Islander
Other Minority
Veteran Status: *
Company Classification (if known):
Disadvantaged Business
Veteran Owned
Minority Owned
Woman Owned Business
Certified HubZone
8(a) Firm
Certified DBE
Certified SDB
Service Connected Disabled Vet
Located in HubZone
Distressed (Labor Surplus Area)
Date Business Established (MM/DD/YYYY) (if not yet established, enter an anticipated future date): *
Date Picker

Federal Tax ID (EIN):
DUNS Code:
CCR Registration Date:
Date Picker

CAGE Code:
Current number of employees:
Estimated number of employees in three years:
Requesting assistance in:
Sales & Marketing
Market Conditions
Understanding Cash Flow
Business Planning
Government Contracting
Personnel Administration
Using New Technologies
Manufacturing / Production
Quality Control
Tax / Legal Issues
FDA Requirements
Managing Employees
Employer Regulations
Website Development
Inventory Control
OSHA & Safety Regulations
How did you hear of us:
Other way you heard about us:

The management and staff Great Plains Business Development Center and it's advisors known as the Recipient, hereby agree that the information in this inquiry and further information gained from follow up interviews and conversations regarding the business, ideas or plans of the submitting party are considered to be Confidential Information. The Recipient shall not furnish or divulge Confidential Information to any external entity without the prior written consent of the Disclosing Party or order from the Court. Examples of businesses that might be found inappropriate would be: one that includes handling of certain hazardous materials, any business deemed illegal, and businesses not in start-up or expansion, etc.

Upon review, we may request that you submit a copy of a business plan for the business planning to be in the Business Development Center. If you require assistance with preparing a business plan, please contact: Jennifer McGrail at (580)250-5556 or or Morgan Gould at (580)250-5553 or

Note that all applicants accepted into the program are subject to a background check.