SBA Form 3310 National Small Business Week SBA Form 3310, Small Busine

OMB Control Number 3245-0360
Expiration Date:

National Small Business Week
SBA Form 3310, Small Business Development Center
Excellence and Innovation Center Award
Instructions: Refer to the National Small Business Week Award Nominations Guidelines
for detailed instructions for submitting nominations.
This form must be completed by the nominee or by the nominator. The completed form must be
submitted with the nomination package as noted in the award guidelines. Answer each question
as fully as possible; if it is not applicable, state N/A.
1. SBDC Information:
a. Name:
b. Address:
c. Phone number:
d. Email address:
e. Website URL:
2. SBDC Director Information:
a. Name:
b. Phone number:
c. Email address:
3. Host organization information:
a. Organization name:
b. Executive director name:
4. Nominator Information (if applicable):
a. Nominator name:
b. Title:
c. Address:
SBA Form 3310 (08/2017) (Previous Editions Obsolete)

d. Phone number:
e. Email address:
5. Fill out the chart below. Additional goals and performance measures can be included in
the “other” categories.
Goal

Actual

%
Achieved

Long Term Counseling
Clients
New Business Starts
Capital Infusion
Client Satisfaction
Other:
Other:
Answer each of the following questions in 200 words or less.
6. Provide a description of the SBDC’s services:
7. Provide a history of the SBDC:
8. Provide a narrative of an SBDC counselor who has excelled in providing counseling,
training and other program services to small businesses:
9. Provide a narrative of a success story relating to a particular business served by the
SBDC:
10. Provide a narrative of how the SBDC has worked with the local SBA District Office as a
champion for SBA products and services including effective amplification of the SBA
mission and priorities and strong education efforts about the SBA and its programs to
small businesses:
11. Provide qualities and performance of the SBDC that merit the award:

Caution: Penalties for False Statements
Knowingly making a false statement on this form is a violation of Federal law and could result in
criminal prosecution, significant civil penalties, and a denial of program participation or other
benefits awarded by the agency. A false statement is punishable under 18 U.S.C. §§ 1001 and
3571 by imprisonment of not more than five years and/or a fine of not more than $250,000 and
under 15 U.S.C. § 645 by imprisonment of not more than two years and/or a fine of not more
than $5,000.
Paperwork Reduction Act Notice:
SBA Form 3310 (08/2017) (Previous Editions Obsolete)

SBA will use the information collected on this form, along with other information submitted
by award nominees as part of the nomination package, to determine the nominee's eligibility
for a particular small business award; to identify any actual or apparent conflict of interest
and, to make eventual award determinations. Responding to this request for information is
voluntary. However, failure to provide the requested information may affect SBA’s ability
to make a decision regarding your eligibility for an award.
You are not required to respond to any collection of information unless it displays a currently
valid OMB control number (3245-0360). The estimated burden for completing this form is 1
hour and 15 minutes, including the time for reviewing the instructions, and gathering and
compiling data. Combined with the time for completing the Form 3300, the total estimated time
to prepare and submit the nomination package for each nominee is 90 minutes. Comments on
this burden estimate should be sent to the U.S. Small Business Administration, Chief, AIB 409
3rd St., SW, Washington, DC 20416, and Desk Officer for the U.S. Small Business
Administration, Office of Management and Budget, New Executive Office Building, Room
10202, Washington, DC 20503. DO NOT SEND COMPLETED FORMS TO OMB. Submit
them to the location indicated in the nomination guide.

SBA Form 3310 (08/2017) (Previous Editions Obsolete)