Name
Email Address
Phone Number
Cellular or Pager
Address
City
State
Zip
Have you owned a business in the past? Yes No
Do you currently own a business? Yes No
Do you have a detailed business plan? Yes No
Have you secured adequate financing? Yes No
What is the general nature of the proposed business?
Have you decided on a name for the proposed business?
Do you have the necessary licenses and/or permits? Yes No
Do you have an office/work space? Yes No
Do you plan to have employees? Yes No
Have you looked into purchasing insurance for your business? Yes No
Additional comments
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