Basic Information Please fill out the details below. If you do not know how to answer any required questions, simply enter "N/A". Page 1 of 6About YouName*FirstLastContact Phone #*Contact Email address*How Many Years in Business?*Not a business owner yetBusiness Owner but has not launched yetLess than 1 year in business Less than 3 years (start-up)Less than 4+ yearsProfessional Business Owner (Small Business)Corporate Company (10+ Employees)NextCompany InformationCompany Legal Name*Company Phone Number*Company Email address*Company WebsiteCompany Facebookplease paste the entire link here. For example https://www.facebook.com/companyFBCompany Physical Address*How is this company structured?Please selectNo Entity Structure (No Business Yet))Sole proprietorshipLLC (Limited Liability Company)LLP (Limited Liability Partnership)INC (Incorporated Entity) For Pro-FitINC (Incorporated Entity) Not-For ProfitPrivate/Public FoundationTrust EntityAdvanced Company Structure (Multiple Structured Entities))OtherHow many Consultants work with your company?Please selectNot Applicable (None)1-2 Company Officers 3-5 Company Officers 6+ Company Officers How many Employees work for your company?Please selectNot Applicable (None)1-2 Employees3-5 Employees6+ EmployeesHow many Patents do you own?Please selectNot Applicable (None)1-2 Patents 3-5 Patents 6+ Patents How many owners have stake in your company?Please selectNot Applicable (None)1-2 Owner/s3-5 Owners6+ OwnersHow many Company Officers work for your company?Please selectNot Applicable (None)1-2 Company Officers 3-5 Company Officers 6+ Company Officers How many 1099 Contractors work with your company?Please selectNot Applicable (None)1-2 1099 Contractors3-5 1099 Contractors6+ 1099 ContractorsHow many Trademarks do you own?Please selectNot Applicable (None)1-2 Trademarks3-5 Trademarks6+ TrademarksBackNextCompany HistoryWhat Products do you offer?Please list your Products here:What Services do you offer?Please list your services here:BackNextHave you registered with the IRS properly?Have you registered with the IRS properly for your industry?Please selectYesNoI dont know what that isHave you registered with the IRS properly for your industry?Do you have all required State Permits/Licences?Do you have all required State Permits/Licences for your industry?Please selectYesNoI dont know what that isDo you have all required State Permits/Licences for your industry?Do you have required permits/licences for your city/county?Do you have a (SBA) Small Business Administration Account? Please selectYesNoI dont know what that isDo you have a (SBA) Small Business Administration Account? Do you have all required professional licences for you industry?Do you have all of the professional licences for your industry?Please selectYesNoI dont know what that isDo you have all of the professional licences for your industry?Do you have a Small Business Administration Account?Do you have a (SBA) Small Business Administration Account? Please selectYesNoI dont know what that isDo you have a (SBA) Small Business Administration Account? Do you have a D.O.D Cage Code Number?Do you have a Commercial And Government Entity (CAGE) Code?Please selectYesNoI dont know what that isDo you have a D.O.D Cage Code/NCode Number? Do you have a SAM's Number?Do you have a System for Award Management (SAM) Number?Please selectYesNoI dont know what that isDo you have a System for Award Management (SAM) Number?Do you have a DUNS Number?Do you have a Dun & Bradstreet D‑U‑N‑S Number?Please selectYesNoI dont know what that isDo you have a Dun & Bradstreet D‑U‑N‑S Number?Does your Company Own Intellectual Property?Does your Company Own Intellectual Property such as Patents, Trademarks, or Copyrights?Please selectYesNoI dont know what that isDoes your Company Own Intellectual Property such as Patents, Trademarks, or Copyrights?Does your Company has Corporate and Industry required Insurance?Does your Company has Corporate and Industry required Insurance?Please selectYesNoI dont know what that isDoes your Company has Corporate and Industry required Insurance?BackNextExplain what your goals are for your company below.*what are some short terms and long term goals you want to accomplishwhat are some short terms and long term goals you want to accomplishBackNextHow would you like to be contacted?How would you like to be contacted?Home / officeMobile / cell phoneEmailMobile TelHome TelEmail address*BackSendThis field should be left blank
