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"BUSINESS PLAN/PITCH DECK" QUESTIONNAIRE
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Email
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Your email
Please answer the brief questions below and click "SUBMIT" to send. Your completing this questionnaire will enable us to maximize your time during the coaching session.
Date Questionnaire Completed
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MM
/
DD
/
YYYY
How did you hear about us?
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Your answer
If applicable, Deadline/Date Materials are Needed for Submission to Potential
Funder?
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Your answer
Year company was Established
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Your answer
Fiscal Year of Business
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Your answer
Entity Type*
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Sole Proprietor
LLC
LLP
S-Corp
Other (please specify): _________________________________________________
In what State is your Business Incorporated?
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Your answer
Owners of Company
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Your answer
Primary Contact
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Your answer
Title of Primary Contact
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Your answer
Email Address
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Your answer
Phone Number
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Your answer
Total # of Current Employees
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Your answer
Mission Statement
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Your answer
What Products and Services do you provide?
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Product/Service #1:
Product/Service #2:
Product/Service #3:
Product/Service #4:
Other (please specify):
Other:
What are the "Suggested Prices" of your Products and Services?
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Product/Service #1:
Product/Service #2:
Product/Service #3:
Product/Service #4:
Other (please specify):
Other:
Target Markets
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Target Market #1
Target Market #2:
Target Market #3
Target Market #4:
Other Target Markets _________________________________________________
Other:
Amount of Capital Needed/Amount of Funds Seeking
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Your answer
Summary of how Capital/Funds will be utilized (Purpose of Funds)
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Your answer
From what Funding Source are you requesting Investment Capital or a Loan?
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Private Investors
Venture Capital/Private Equity
Bank
SBA
Other (please specify)
If applicable, What Percentage of Ownership Equity/Stock (Shares) are you offering in exchange for a capital investment?
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Your answer
Annual Revenue the last 3 years:
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Year 1:
Year 2:
Year 3:
Projected Revenue for the next 5 years:
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Year 1:
Year 2:
Year 3:
Year 4:
Year 5:
Are current Financial Statements Available? (Profit and Loss; Cash Flow; Balance Sheet)
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Yes
No
Have Tax Returns been filed (last 3 years)?
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Yes
No
Which of the following items below have already been prepared?
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Pitch Deck
Pro Forma (3 to 5 Years)
3 to 5 Page Executive Summary/Investment Summary
Business Plan
A "Live" Website
Brochure/Other Written or Promotional Materials
Resumes/Bios of Management
Other Items (please specify):
If any, how much Cash Collateral do you have to provide a lender if required to secure funding?
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Your answer
What other Assets can be provided as Collateral for obtaining funding? (Equipment, Real Estate, Facilities, Accounts Receivable, Inventory)
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Your answer
What are your Debts/Liabilities (Loans, Property Leases, Other)?
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Your answer
If needed to qualify for funding, what is your Personal Credit Score?
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Your answer
If needed to qualify for funding, what is your Business Credit Score?
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Your answer
Are you currently working with a Lender/Investor? If Yes, has the Lender/Investor shared specific information they would like to be provided to assist them in making a final decision about funding your project?
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Your answer
EXIT STRATEGY (How long do you plan to own the business? Do you plan to sell the business, merge with another company, or take the company public?)?
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Your answer
Please provide a minimum of "3 Days and Times" that are most convenient for you to schedule your Initial Consultation Virtually or In-Person? (Request #1, Request #2, and Request #3)
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Your answer
A copy of your responses will be emailed to the address you provided.
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