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´╗┐SBOP

Small Business

Opportunity Program


APPLICATION FORM -Clark County SBOP - 2022


* 1. Today's Date:
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* 2. Business Name:
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* 3. DBA (Doing Business As):
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* 4. Number of Years in Business:
* 5. Located in Clark County District:

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* 6. Owner's First Name:
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* 7. Owner's Last Name:
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* 8. Point of Contact First Name (the person who will be enrolled and communicate with SBOP):
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* 9. Point of Contact Last Name (the person who will be enrolled and communicate with SBOP):
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* 10. Point of Contact Email:
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* 11. Point of Contact Phone Number:
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* 12. Business Street Address:
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* 13. City:
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* 14. State:
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* 15. Zip Code:
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* 16. Business Phone:
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* 17. Business Email:
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* 18. Website:
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* 19. Briefly describe the type of products/services you provide:
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20. Please select the description which best describes 51% or more of the business ownership:
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21. Company's certification status:
22. Please select the box that best applies to 51% or more of the business ownership:
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23. NV State Business License Number (if applicable):
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24. NV State Business License Expiration Date:
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25. Clark County Business License Number (if applicable):
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26. Clark County Business License Expiration Date:
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27. Other City/County Business License Number (if applicable):
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28. Other City/County Business License Expiration Date:
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