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2. Section A
4. Full Name*
5. Date
7. Title
8. Business Name
10. Phone Number*
11. Email Address*
12. Best Way to Contact

    1. Phone
    2. Email
14. Website
15. Other
17. Address*
19. City*
20. State*
21. Zip Code:*
23. Referred by

    1. Personal Referral
    2. Newspaper

    1. Website
    2. Other

    If Other or Personal Referral, please specify to the right
24. Personal Referral/Other
26. Seeking the following services (Check all that apply)*

    1. COVID-19 Assistance/Inquiry
    2. Space/Building (If checked, fill out Section B)
    3. Information on starting a business (Permits/Licensing)
    4. Financial Assistance

    1. Tax Incentive Programs
    2. Lowell Market Data
    3. Workforce Training
    4. Other

    If Other, please specify on the right
27. Other
31. Section B (If Applicable)
33. Property Type (Check all that apply)

    1. Building
    2. Business
    3. Land

    1. Space
    2. Co-Working Space
    3. Other

    If Other, please specify to the right
34. Other
36. Market Status (Check all that apply)

    1. Lease
    2. Sale
    3. Sublease
37. Timeframe to Find Building/Space

    1. Within next 6 months
    2. Within next year
    3. Over 1 year
38. Area Square Foot Needed
40. Use Type (Check all that apply)

    1. Industrial
    2. Institutional
    3. Mixed Use
    4. Office
    5. R&D

    1. Residential
    2. Restaurant
    3. Retail
    4. Warehouse

    1. Downtown Office
    2. Co-Working Space
    3. Makers Space
    4. Other

    If Other, please specify on right
41. Other
43. Specific Needs (Please explain below)

    1. Loading Dock
    2. Ceiling Height
    3. Weight Capacity
    4. Floor Preference
    5. Handicapped Accesibility
    6. Power Capacity
45. Notes & Specific Needs
Leave This Blank:


49. 1. Receive an email copy of this form.
50. Email address

    This field is not part of the form submission.

51. Submit

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