Thank you for your interest in the WTAMU Enterprise Center.
 
Please fill out the following information about your business. A member of our staff will contact you within the next 3-5 days regarding your inquiry. If you would like to speak with someone sooner, please call us at 806.374.9777.
 
Contact First Name:*
Contact Last Name:*
Title
Email Address*
Company Name*
Phone Number*
Mobile
Fax
Address*
City*
State*
Zip Code*
Website
Are you currently or do you have future plans to receive 75% of total revenues from outside Potter and Randall Counties?*
Yes No
Please list all persons with 20% or more ownership in the business:*
Form of Business:*
Sole Proprietorship
Incorporated
Partnership
LLC
Not Incorporated at this time
Other
Year business was started:*
Product & Service Description:*
How did you hear about us?*
Internet Search Engine
Email
Direct Mail
Newspaper
Billboard
Magazine
Television
Radio
All of the information provided in this inquiry is accurate and complete to the best of my knowledge and I am authorized to release this information. I certify that I have not submitted any confidential or proprietary information and acknowledge that no confidential relationship has been established with the WTAMU Enterprise Center.*
Yes No

 
* Indicates field is required.