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 Name Last Name

Address

Phone Number

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

Yes No
What is your level of education?
Are you currently employed?

Yes No
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?
Have you owned any businesses or been self-employed?

Yes No
If yes, please describe.
Have you researched any business ownership options in the past?

Yes No
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
Worst						Best

Sales

	1	2	3	4	5
Worst						Best

Leadership

	1	2	3	4	5
Worst						Best

Problem Solving

	1	2	3	4	5
Worst						Best

Sales & Marketing

	1	2	3	4	5
Worst						Best

Delegation

	1	2	3	4	5
Worst						Best

Administration

	1	2	3	4	5
Worst						Best

Accounting

	1	2	3	4	5
Worst						Best

Self-Employment Profile