Opportunity You

Self-Employment Profile

Please complete your Self-Employment Profile below to help us to better understand and evaluate your background and current situation.
Name*

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number

Area CodePhone Number
Email*
example@example.com
Best Time To Call
Age
If college, What type of degree?
Are You a Veteran?

YesNo
What is your level of education?
Are you currently employed?

YesNo
If your answer is yes, is it Full-Time or Part-Time Employment?
If you're currently employed, please tell us the type of company.
If you have a spouse or significant other what is their name?
How involved will they be in your new business?
What are your primary reasons for a possible career change, exploration of business ownership, or investment in a business?
Businesses can operate out of various places. With business ownership, you have control over where you would like to go to work every day. Please tell us your preference from one of the following: Work From Anywhere, Home Office, Office Space/Building, Retail Location.
Approximate time-line - If you were to decide to own your own business, approximately how soon would you like to begin the operations of this potential new business?
What is your approximate net worth?
(I need to know this so that I can determine which business opportunities you will financially qualify for.)
Have you owned any businesses or been self-employed?

YesNo
If yes, please describe.
Have you researched any business ownership options in the past?

YesNo
If yes, please describe.
Please rate yourself on a scale of one to five in the following areas:

People Skills*

	1	2	3	4	5

1 is Worst, 5 is Best

Sales*

	1	2	3	4	5

1 is Worst, 5 is Best

Leadership*

	1	2	3	4	5

1 is Worst, 5 is Best

Problem Solving*

	1	2	3	4	5

1 is Worst, 5 is Best

Sales & Marketing*

	1	2	3	4	5

1 is Worst, 5 is Best

Delegation*

	1	2	3	4	5

1 is Worst, 5 is Best

Administration*

	1	2	3	4	5

1 is Worst, 5 is Best

Accounting*

	1	2	3	4	5

1 is Worst, 5 is Best

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Self-Employment Profile