DTI Negosyo Center AglipayBusiness Counseling · Municipality of Aglipay
FORM FM-BC-01a
Rev. 1 · 15-Nov-22

Business Counseling Form

Complete Section I below to request business counseling from DTI Negosyo Center Aglipay. A Business Counselor will review your request and complete the rest of the form during your session.

privacy_tipData privacy consent

I hereby consent to the collection and processing by the DTI of my name, contact details, and information on its services for the purpose of monitoring, measuring, analyzing business counseling service and of improving DTI services. I shall notify DTI in any case of any changes in my personal information.

This consent shall be valid, unless revoked or withdrawn in writing subject to the applicable provisions of the Data Privacy Act of 2012 or Republic Act no. 10173.

1
Client Info
2
Business & Request
3
Review & Confirm

Your progress is saved in this browser tab automatically.

Section I. To be filled up by Client

Personal details, exactly as they should appear on your counseling record.

badgeComplete name
Required.
Required.
groupsSocial classification & sex
Please select one.
Please select one.

Business address & your request

Still Section I — where to find your business, and what you'd like help with.

storefrontBusiness
Please enter your business name.
location_onAddress
Required.
callContact details
Enter an 11-digit Philippine mobile number starting with 09.
Enter a valid email address.
quick_reference_allDetails of request/query
Please select a request or query.

Review before you submit

Please make sure everything is correct — you can still go back and edit any section.

I confirm that the information provided above is true and correct.

check

Submission received

Your Section I details have been sent to DTI Aglipay. A Business Counselor will complete Section II of your form and contact you using the details you provided.

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