EmailMe Form - NM Rural Efficient Business Program

Check which workshop you would like to attend: *

3/19/19 GALLUP

Name *

First Last

Email *

Phone *

### - ### - ####

Company Name *

If you are not a business owner, with what organization are you affiliated?

Address *

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region

Industry *

NAICS Code

Number of Employees *

Are you a registered business? *

Yes

No

What type of entity is your business? *

How long have you been in operation? *

Revenue Levels

<$500,000

$500,000-1M

$1M+

Not currently generating revenue

Do you generate 50% or more of your revenue from out of state?

Yes

No

Have you received assistance from the following?

Manufacturing Extension Partnership

Small Busineess Development center

Other

If other, please explain

Are you interested in learning about financial opportunities for expanding?

Yes

No

Apply for an Energy Site Assessment

Energy Site Assessments are available for rural businesses and agricultural producers. The assessments will be conducted by a certified engineer from NM Energy Minerals and Natural Resources Department for a highly discounted price: $25. If you are selected, you will be contacted to schedule the assessment. If you are interested, please fill out the following information to apply

Facility Address

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region

Facility Square Footage

Does EMNRD have permission to access facilities? Date will be arranged with you.

Yes

No

Does the facility use LED lighting?

Yes

No

Are there comfort issues (too hot, too cold, etc.)?