Contact Information: Company Information: State*AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareWashington DCFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming Tell Us About Your Business: *Stage of Business? Research or info-gathering onlyPre-licensed (e.g. LLC)Pre-productionActive productionPaused productionLess than 1 year active production2+ years active production1-5 employees5+ employeesOther Tell Us About You The following questions are for internal reporting purposes only. Responses have no effect on assistance received. Your responses will help us understand the income levels within our community and support our efforts to comply with the Community Reinvestment Act (CRA). The CRA encourages financial institutions to help meet the credit needs of the communities in which they operate, including low- and moderate-income (LMI) neighborhoods. *How did you hear about CIFT small business services and NOCK? —Please choose an option—Friend/RelativeSocial MediaInternet SearchCIFT EventOther *Ownership and Financial Details Women-ownedVet-ownedUnder $1M in salesHousehold income under $65,000/yrN/A or Prefer Not to Answer *Ethnicity (Check option that best applies) This information will be held in confidence and does not impact availability of services. —Please choose an option—White/caucasianBlack or African AmericanHispanic/LatinxNative American or Alaska NativeNative Hawaiian or Pacific IslanderMiddle Eastern or North African (MENA)MultiracialPrefer Not to AnswerOther How Can We Help? *Would you like to learn more about utilizing the Northwest Ohio Cooperative Kitchen for your production? Note that each business is responsible for soliciting their own workforce. NOCK does not provide co-packer services. See NOCK FAQ. —Please choose an option—YesNoUnsure If interested in utilizing the NOCK, select all that correspond to your current state of business: No active productionHobby or temporary useCottage foods operationCurrently utilizing other commissary (commercial kitchen)Currently utilizing co-packerCatering or meal prep (RTE)Mobile unit (food truck, trailer, cart, tear-down)Packaged good (CPG)Expansion of existing businessProcessing raw meat, dairy, or alcoholUnsureOther *Would you like to learn more about CIFT small business support services available to accelerate your company/product? —Please choose an option—YesNoUnsure *Are you in need of any of the following CIFT Small Food Business Assistance Services? Check all that apply. This list is not all-inclusive. If looking for other support, please describe in “other.” Retail Readiness ConsultationeCommerce SupportNutritional Fact Analysis ServiceContract Manufacturing Support (Co Packer)Food Broker & Expo Program with CIFTNOCK Mock Production (R&D in commercial kitchen with CIFT Staff Support)Labeling & Packaging SupportInformation on 3PL distribution companiesFood Service Workflow Optimization (Consultation and site review for existing food service business)Specialty Beverage Menu Creation & Recipe DevelopmentBarista EducationOther *What is your projected timeline to receiving this outcome? —Please choose an option—No expected timeline or info-gathering only2–4 weeks4–8 weeks3–6 months6+ monthsUnsure or wanting assistance on timeline creation
