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Please complete the application below, and email it with the required <br />documentation for processing to: <br />Tom Kindred, Regional Director <br />FL Small Business Development Center at IRSC <br />fsbdc@irsc.edu <br />Please scan your application and all supporting documents into one <br />document (pdf), to send in one email or as one combined file. <br />Company Information <br />Full Legal Business Name: <br />Please indicate your business strucfure`(Choose one): <br />Y Sole Proprietor or Partnership <br />Y C -Corporation or S -Corporation' <br />Y Limited Liability Company,(LLC) <br />Y 1099 Employee-,. <br />Please indicate yourlbusiness type (must be hospitality related — i.e., restaurant, <br />bar, tour operator, hotel,dive''-shop, beach rental, RV park, personal services, etc.) <br />Business Phone Number: ` Cell Phone Number: <br />Current Business Address: <br />City: State: FL Zip: <br />Mailing Address, if different from above: <br />Website: <br />162 <br />