CEDF Program Registration

For small business financing or business support services and resources.

Are you a nonprofit organization?  Use a different form found here.

CEDF is a nonprofit community lender and a U.S. Treasury-certified Community Development Financial Institution. In order to provide business support services and financing at reduced or no cost, we must maintain philanthropic funding from government, corporate and charitable sources. This requires we measure and demonstrate the impact of our mission, so we ask our program recipients to provide personal and business information required. We share your information only in aggregate from unless required by the U.S. Small Business Administration as a participant in one of their programs and as authorized by you. We greatly appreciate your cooperation in completing our intake form.

Full text of the SBA Navigator user agreement is at this link.

(* Denotes Required Fields)

How Can We Help?
My primary need is: *	To obtain a business loan To obtain advice or business education support Both
For businesses seeking loans, choose the primary purpose(s):	Buy a building Equipment Inventory Working capital Buy a business Refinance debt
How much do you think you need to borrow?:
For loan inquiries: This form registers your interest with us and allows us to follow up and answer your questions before you submit a formal application. The inquiry is not a formal application. Once you complete the inquiry form, you will be able to download the application form, instructions and more information about the required supporting documents needed. We'll be happy to help guide you through the process.
Business Owner Information
First Name: *
Last Name: *
Email: *
Phone Number: *
Is your phone number::	Cell Home Business
Business Information
Legal Business Name (or "not yet named"): *
DBA or Trade Name (How Customers Know You):
Years in Business (Zero if not yet started): *
Date the business opened (When you registered the company): *
Estimated annual revenue (gross sales): (Zero if not yet operating):
Number of full-time employees (35 or more hours per week - includes small business owner): *
Number of part-time employees (34 or fewer hours per week): *
Legal structure of business: *	Sole proprietor/Unincorporated Limited Liability Company Corporation (S Corp, C Corp or other type) Partnership (General and Limited) Nonprofit Legal entity type not yet determined
Choose one category that best describes your industry: (Numbers represent NAICS code prefixes -- internal use): *	Accommodation, Food Services (72) Admin Support, Waste Management, Remediation Services Agriculture, Forestry, Fishing and Hunting (11) Arts, Entertainment, Recreation (71) Child Daycare Services (624,410) Construction (23) Educational Services (61) Finance and Insurance (52) Health Care, Social Assistance (62) Information (51) Management of Companies & Enterprises (55) Manufacturing (31-33) Mining, Quarrying, Oil, Gas Extraction (21) Professional, Scientific, Technical Services (54) Real Estate Rental and Leasing (53) Retail Trade (44 - 45) Transportation and Warehousing (48 - 49) Utilities (22) Wholesale Trade (42) Other Services (81)
Business Primary Address (or your planned location) Enter "N/A" if not established.
Street: *
City: *
State/Province: *
Zip/Postal Code: *
County:
Select which best describes your business location:	Commercial property is owned Leased commercial space for the business Business is home-based (business is primarily operated out of my personal residence) Business is mobile (example: food truck, ride share, fishing boat) Co-Working / Shared Space
Demographics
Gender: *	Male Female Non-binary Other Prefer not to respond
Race (Check all boxes that apply): *	American Indian/Alaskan Native Asian African American/Black Caucasian/White Hawaiian/Pacific Islander Other Prefer not to respond
Ethnicity: *	Hispanic Non-Hispanic Prefer not to respond
Do you and your business identify as any of the following (where ownership is based on 50% ownership or more?): *	Disability-Owned Business Enterprise LGBTQ+ Owned Business Enterprise Minority-Owned Business Enterprise Veteran-Owned Business Enterprise Woman-Owned Business Enterprise Justice-involved/returning citizen - Owned Business Enterprise Refugee-Owned Business Enterprise Immigrant-Owned Enterprise Limited English Proficiency-Owned Business Enterprise Not Applicable Prefer not to respond
Are you and your business a government-certified Disability-Owned, LGBTQ+ Owned Business Enterprise, Minority-Owned, and/or Woman-Owned Business Enterprise (where ownership is based on 51% ownership or more? Check all that apply:	Disability-Owned Business Enterprise LGBTQ+ Owned Business Enterprise Minority-Owned Business Enterprise Veteran-Owned Business Enterprise Woman-Owned Business Enterprise Not applicable Prefer not to respond
Business Owner Household Information
We ask these questions to qualify you for available lending or business assistance services.
Is the primary business owner a female head of household?:	Yes No
Number of household members (includes business owner):
Household Annual Income (Based on your most recent IRS 1040 Adjusted Gross Income -- line 11): *
Referral and Comments
How did you hear about CEDF?:	Search engine CEDF website CT Small Business Development Center (SBDC) SCORE Small Business Administration (SBA) Another CEDF client Seminar/ webinar/ business event Bank Women's Business Center Other
Name of person or bank who referred you:
Please briefly describe your business and how we can help. Anything else we should know?: *
Agreement
CEDF is a participant in the SBA's Community Navigator program which may require your authorization. Should I request business counseling service from CEDF through the Small Business Administration (SBA) Community Navigator program. I agreed to cooperate should I be selected to participate in surveys designated to evaluate SBA services. Link to the full text of the agreement is show at the top of this form.
I permit SBA or its agent the use of my name and address for SBA surveys and information mailings regarding SBA products and services: *	Yes No
Please type your full name to agree:
I want to stay updated on CEDF program offerings.