211 Warren Street l Newark, NJ 07103 l 973.353.0611 l www.ifelnj.org
NUEZ/IFEL Small, Minority, and
Women-Owned Business
Technical Assistance Program
Application
Business Category
Business Name
Contact Name
Title
Business Address
(Actual or proposed)
City, State Zip
Phone
Fax
Email
Website
1.  Current stage of development: select one
2. # Years in Business
3. # of Employees
4.  2009 Revenue: select one
5. Minority/Women Ownership %
6.  Certifications:
UEZ
Other: (please specify)
7.  With what areas do you feel you need the most immediate help?
8.  How do you think your participation in the UEZ/IFEL Small,
Minority and Women Business Technical Assistance Program
can benefit your business?
9.  How did you hear about IFEL?