Event Registration
NW LA Procurement Technical Assistance Center

Title of Event: SBA Certifications
Event Location: Hamilton Branch Library (Comupter Tech Lab)
Event Address: 2111 Bert Kouns Ind. Loop
Event City: Shreveport
Date of Event: October 23, 2017
Start Time of Event: 1:00 pm
End Time of Event: 5:00 pm
  * Green Fields are required
Company Name:
Attendee Name:
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Same as Physical Address:
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If this is your company's first time to contact the NW LA Procurement Technical Assistance Center,
please complete the following:

Avg # of Employees (last 3 yrs):
Avg Yearly Gross Sales (last 3 yrs):
Date Business Was Established:    [YYYY-MM-DD or MM/DD/YY]
Have you previously done business with any government agency or prime contractor?
Yes No Don't Know
Business Ownership:
Check all that apply. (Defined as 51% owned and controlled.)
Woman-owned Minority-owned Veteran-owned
Service Disabled Veteran-owned
Business Certifications and Determinations:
Check all that apply.
Disadvantaged Business
Certified HUBZone
Small Business
Generally describe or list the products or services you wish to offer to the government:
List the types of services you might want to receive from our center:
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By submitting this registration I give consent to NW LA Procurement Technical Assistance Center to provide my company with PTAC client services.