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Application Form for Biz Owners Ed

4th Annual 10-Week Program Commencing January 12, 2016

 

Please fill out the following form to be considered for Biz Owners Ed

Name________________________________________________________________________________

                               

Company Name________________________________________________________________________

 

Address______________________________________________________________________________

 

City________________________________________  State_________  Zip________________________

 

Email_______________________________ Website:  _________________________________________

 

Phone (Office)___________________________(Mobile)_______________________________________

 

What percentage of your business do you own?_____________________________________________

How long have you been in business?______________________________________________________

Annual Sales Revenue___________________________________________________________________

Number of Employees________________________  Number of Senior Staff______________________

Number of hours you work per week______________________________________________________

Number of days you spend traveling for work per week_______________________________________

Were you profitable in 2014?____________________________________________________________

Do you belong to any entrepreneurial groups/organizations (please list):_________________________

_____________________________________________________________________________________

Please describe your business and what it does or makes:

_____________________________________________________________________________________

_____________________________________________________________________________________

What are your key differentiators? What’s innovative about what you are doing?

_____________________________________________________________________________________

_____________________________________________________________________________________

Comments:_____________________________________________________________________________

_____________________________________________________________________________________

 

Mail your application form to:  1277 Porter Rd, Flower Mound, TX 75022
OR fax it to 817-430-0853 attention Cari Schweichler
OR email it to jdr2psr@airmail.net