Intake Form

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BRC Intake Form

Thank you for visiting! Please take a moment to fill out this form so we can direct you to the most appropriate resources or support.
Steps 1: Fill out intake form
Step 2: Attend open office hours to meet with staff
Step 3: Schedule a one-on-one meeting

First name*

Last name*

Email*

Phone (Please put a 1 first)*

Organization name (if applicable)

What is your organization type? (Please check one) *

Small Business

Municipality (City, Town, Local Government)

Nonprofit

Other

What are you seeking assistance with? (Please check all that apply) *

General Business Resources: Marketing, Business Planning, Website Development

Networking Opportunities

Financial Planning

HR Resources

Grant Assistance (Research, Eligibility, Strategy)

Government Procurement

Access to Capital

Other

Of these services, which is your primary focus?

Have you worked with any service providers previously? If so, please list which organizations.*

To discuss these services, please visit during our open office hours, held every Tuesday from 10 AM to 3 PM at our office at 235 W Main Street, Monongahela.

Preferred method of communication/contact*

In person meeting

Phone Call

Video Call

Other

What hours work best for you?*

Morning (9am-11am)

Afternoon (12pm-4pm)

Other

Why are you seeking support? (Briefly explain what led you to seek resources or support today.) *

How did you hear about us? (Please check one) *

Referral (Friend, Colleague, etc.)

Online (Website, Social Media)

Flyer/Brochure

Event (Conference, Workshop, etc.)

Other

Anything else we should know? (Feel free to provide any additional details or questions you have.)

The next step after you submit this intake is to attend our Open Office Hours. These are held every Tuesday from 10 AM to 3 PM at the BRC, located at 235 W main Street, Monongahela. We look forward to seeing you there!

Get in touch!

235 West Main Street,

Monongahela, PA 15063

724-565-5636

BRC@monvalleyalliance.org

First Name

Last Name

Company

Position

Message

Thanks for submitting!

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BRC Intake Form

Thank you for visiting! Please take a moment to fill out this form so we can direct you to the most appropriate resources or support. Steps 1: Fill out intake form Step 2: Attend open office hours to meet with staff Step 3: Schedule a one-on-one meeting

Thank you for visiting! Please take a moment to fill out this form so we can direct you to the most appropriate resources or support.
Steps 1: Fill out intake form
Step 2: Attend open office hours to meet with staff
Step 3: Schedule a one-on-one meeting