Business Incubator - Intake Form
Answers marked with a * are required.
1.
Business Intake Form
In order for us to properly assist you in achieving your business goals, please complete this form and you will be scheduled for a free 20 minute consultation with (DBC) Detroit Business Coach - Dr. Victoria Brown
1.
Complete The Following Information
*
Today's Date
Contact Name
Business Name
Street Address
City/St/Zip
Phone
Email
2.
Type of Business
*
For Profit
Non-Profit
Do Not Know
3.
Company Size
*
Small (1-5)
Medium (6-20)
Large (21 +)
4.
What business services do you believe is needed?
*
Business Assessment (You want to explore different business ideas)
Business Coaching (You believe you will benefit from weekly-monthly sessions)
Business Corp Development (You need assistance in incorporating your business)
5.
What products are you interested in discussing as it relates to your business?
*
Business Plan
Program Development
Purchasing a business ($150.00 - $700 Investment)
Accounting/Tax Serices
Networking Opportunities
Staff Training and Inservice
Human Resources Development
Business Trusts & Assest Protection
Merchant Services (Credit card processing)
Ministry Consulting
Accreditation Preparation
Grant Writing
Legal Services
Program Evaluation/Research
Business Insurance Coverage
Credit Restoration
Business Financing
6.
What are your marketing needs?
*
Web Design/Development
Social Media Marketing (Twitter, FB, etc)
Mobile Application Development
Business Cards
Corporate Branding/Structure
Brochures
Flyers
Letterhead
Graphic Designs
Other (Please Specify)
7.
Do you need assistance with personal taxes?
*
Yes
No
8.
How would you rate your personal credit?
*
Poor
Below Average
Average
Good
Excellent
9.
Are you looking for business financing?
*
Yes
No
10.
If you answered YES to business financing YOU MUST go to
www.creditchecktotal.com
to pull your personal credit. Have your username and password available for the initial consultation.
11.
Would you like to know more about the Jireh Business Consulting Business Incubator?
- The purpose of this program is to grow businesses from potential to possibility -
*
Yes
No
Maybe
12.
What are some of your business concerns for getting started?
*
13.
What goals do you have for your business?
*
14.
On the average, how much do you anticipate having available to invest in yourself to start this business?
*
15.
What other questions do you have related to you business?
*
16.
How did you hear about our services?
*
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