Business Plan Intake Form

Business Plan Intake Form
Hi There!

Thank you again for allowing Black To Business to be a part of your business planning journey. Please take some time to complete the following questionnaire. The more information you can provide, the better.
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Quantity
Your Name*

First NameLast Name
Your Company Name*
Your Website
Your Email Address*
example@example.com
Your Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Secondary Number
Please enter a valid phone number.Format: (000) 000-0000.
What is the name of your product/service?
How does your product/service work?
Please provide a detailed description.
What is the name of the individuals involved in the business, and what are their positions?
What industry does your business belong to?
What are the main cities your business is targeting?
What is the reason behind starting your business?
Include your mission statement. If you do not have one, we can provide you with one.
What is your vision statement?
Where are you located (geolocation)? Your business address?

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
What or who is the competition in your industry?
What is your business objective?
Who are your target markets?
If using a website describe your Ecommerce platform.
What is the level of experience you have in this industry?
- Please provide a short biography leading up to the point you started the company.
- YesNo
- How much are you selling your product(s) for?
- How much revenue do you expect to generate in the first year of operation?
- YesNo
- How much in rent do you pay for office space?
  Complete if you answered NO on the previous question.
- How much are you asking for from your investor?
- What are the costs of the monthly expenses you expect to incur? Please list them along with the cost.
- Monthly Expenses
- Rent
- Phone
- Website
- Advertising
- Office Supply
- Insurance
- Are there any assets or liabilities you presently carry (Loans, Pensions, and IRA/401K)? If yes, please list them.
- When and what are the steps you plan to take to make your business successful?
- Financial Analysis
- How much net profit are you anticipating to make in your first, second, third, fourth, and fifth years?
- Please list some expenses you would incur in the course of operation. Indicate each expense with the price if it is a monthly or yearly expense.
- At what rate would you be offering your services, and at what profit margin (percentage?)
- How many staff members do you have? Please give a salary scale for each staff member.
- Any form of Loan or Investment? If any, please state and give % on interest.
- Owner investment or shareholder contribution?
- Startup Expenses
- Startup Assets
- Milestone
  
  This is where a business plan becomes a real plan, with measurable activities, instead of just a document.
- Include as many specific programs as possible. For each program, give it a name, a person responsible, a milestone date, and a budget.
  Note that all the above information is very important. You don’t have to be accurate; you can just give an estimate but note that the financial plan will be based on the estimate given. ANY OTHER RELEVANT INFORMATION YOU THINK WILL HELP WHILE PREPARING INVESTORS FINANCIAL PLAN IS HIGHLY WELCOME.
- Comments or Special Instructions:
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Business Plan Intake Form

Hi There!

What are the costs of the monthly expenses you expect to incur? Please list them along with the cost.

Financial Analysis

Startup Expenses

Startup Assets

Milestone