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Eligibility Application
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Email
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Your email
First & Last Name, Business Name
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Your answer
Phone
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Your answer
What product or service do you offer?
State succinctly but thoroughly (Not "plumber," but "repair, install and maintain plumbing systems on a 24/7/365 basis to residential customers").
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Your answer
Number of employees:
1) Full time
2) Part time
3) Total hours worked
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Your answer
Monthly revenue:
1) For the last 3 months
2) For the last 12 months
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Your answer
Projected revenue:
1) For the next 3 months
2) For the next 12 months
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Your answer
What is your number one perceived problem that you need to solve urgently?
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Your answer
What is the number one perceived problem that others think you need to solve urgently?
e.g. investors, lenders,
employees,
family
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Your answer
Implication:
1) What are the consequences of not solving the problem?
2) What are the consequences of solving the problem?
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Your answer
What are you willing to invest?
1) t: Number of hours, weeks, months
2) $: How many materials, assets, labor dollars are you willing to commit?
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Your answer
What would you expect in return?
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Your answer
How will you know...
1) you succeeded?
2) it's time to try something else?
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Your answer
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