Client or Company Requesting Technical Assistance
Client or Company Name *
Contact Name *
Phone Number *
Fax Number
Title
Email Address *
Street Address *
Mailing Address
City *
State *
Zip Code *
Number of Employees
SIC/NAICS Code
Percent Foreign-Owned
Technical assistance requested or nature of problem and its symptoms
Feedback from INL employee
INL employee(s) providing technical assistance
Describe the technical assistance provided
Give a summary of efforts and results of technical assistance (not any difficulties with process or interaction)
Feedback from Client or Company
Please describe your experience with INL's Technical Assistance Program
Do you feel that your request for technical assistance was fulfilled and that the technical assistance provided to you achieved the desired outcome?
Please explain
How will the technical assistance provided to you help in the development of your business?
Based on your experience, how can INL improve its technical assistance program?
Additional Comments