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33
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1
Are you located in the United States?
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YES
NO
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2
First Name
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3
Last Name
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4
Email Address
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5
Phone Number
Area Code
Phone Number
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6
How are you interested in partnering?
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I'm a business leader interested in serving as a mentor.
I'm a business owner looking for mentorship.
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7
Name of Employer
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8
Current Position
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9
Please list all the industries where you have experience:
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10
For the following five questions, please check off the areas you are comfortable mentoring and advising entrepreneurs on. If you are not comfortable in one area, simply click "skip."
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11
Accounting & Finance
If none of these areas apply to you, click "ok" to continue to the next group of areas...
Business Accounting / Budgeting
Cash Flow Management
Finance/Valuation
Tax Planning
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12
Sales & Marketing
Customer Acquisition / Relations
Market Research / Competitive Analysis
Consumer Software
E-commerce
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13
Operations & Execution
Technology & Computers
Product Supply
Crises Management/Recovery
Human Capital Management
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14
Legal & Governance
Incorporation
Crises Litigation
Government Contracting
International Trade
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15
Leadership & Management
Business Strategy
Communication
Conflict Management
High-Performing Teams
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16
SBMI works in partnership to provide Mentors for two other organizations, IFEL and ICIC. The following questions are designed to understand your interest/possible fit with their programs:
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17
Would you have an interest in helping with Capital Raising (not a requirement)?
YES
NO
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18
Are you interested in being on a ‘Skilled Resources’ List to help other Entrepreneurs (besides the one you are assigned to Mentor) on a more limited basis?
YES
NO
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19
What else would be helpful for us to know in order to match you with a small business owner?
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20
Name of Company
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21
Industry
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22
What was your revenue in the last 12 months?
Choose the range that best represents the total number of dollars your business brought in during the last 12 months.
$0-5,000
$5,000-$50,000
$50,000-$100,000
$100,000-$250,000
$250,000+
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23
How long have you been in business?
Less than 6 months
6–12 months
12–24 months
24+ months
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24
Where is your business located?
City and state, please.
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25
For the following five questions, please check off the areas you would like help from mentoring. If you do not need help in a given area, simply click "skip."
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26
Accounting & Finance
Business Accounting / Budgeting
Cash Flow Management
Finance/Valuation
Tax Planning
Skip
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27
Sales & Marketing
Customer Acquisition / Relations
Market Research / Competitive Analysis
Consumer Software
E-commerce
Skip
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28
Operations & Execution
Technology & Computers
Product Supply
Crises Management/Recovery
Human Capital Management
Skip
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29
Legal & Governance
Incorporation
Crises Litigation
Government Contracting
International Trade
Skip
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30
Leadership & Management
Business Strategy
Communication
Conflict Management
High-Performing Teams
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31
Are there any other topics not listed above that are a priority for you to receive Mentoring help?
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32
What else would be helpful for us to know in order to match you with a Mentor?
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33
Thank you! We are reviewing your application and will reach out soon.
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