Fill out our Confidential Questionnaire. We will contact you as soon as possible after we receive your inputs. Thank you!
Education (high school, college, graduate degree)
What have you liked most about your past employment?
What have you liked least about your past employment?
Using a scale of 1 to 10 (with 10 being the highest level of interest, and 1 being the lowest), please rate your personal interest in the following areas:
Describe how much you would enjoy the following roles
In what areas would you prefer to own and operate your business? (Please list city/state)
What do you want your role in the business to be? (Please check top choice)
How would you rate the following?
(Please use rough estimates. Do not include account numbers, etc.)
The following information is requested because any affirmative answers may have a direct bearing on your ability to obtain financing for starting a business. This is a critical factor in determining which companies may match with your criteria.