PowerLink Discovery Form

Thank you for your interest in PowerLink. Below is our business discovery form we ask you to complete so we can better assist you and your business.

Question Title

* 1. I am interested in learning more about:

Attending an event as a Business Owner or Presenter

Attending an event as an Audience Member

Becoming an Advisor

Obtaining a PowerLink Custom Advisory Board

Joining a CEO Circle (Community Advisory Board)

Other

Question Title

* 2. Company and Contact Information

Applicant Name and Title *

Company Name

Mobile Phone Number

Company Address

Company City/Town

Company State/Province

Company ZIP/Postal Code

Company Phone Number

Company Email Address

Company Website

Question Title

* 3. Complete the following information:

Year Company was Founded

% of Company Owned by Applicant

Number of Full-Time Employees

Number of Part-Time Employees

Number Sub-Contracted (1099 Employees)

Industry

List any other owners and their percentage of ownership:

What is your business structure and what areas do you operate?

Question Title

* 4. Is your company a certified?

DBE

MBE

VOSB

WBE

Other (please specify)

Question Title

* 5. Are Financial Statements Available?

Yes

N/A

Question Title

* 6. Describe your company's products and services or your expertise:

Question Title

* 7. Describe your company's greatest growth challenges:

Question Title

* 8. Initial thoughts on how we might be able to help - what are you looking for?

Question Title

* 9. List up to three best dates/times on Fridays to schedule a 30-minute follow-up interview to discuss your business in more detail:

Question Title

* 10. How did you first hear about PowerLink?

News article

Word-of-mouth referral from friend

Online search (e.g., Google, Yahoo, Bing)

Online forum/discussion board

Social media (e.g., Facebook, Twitter)

Other (please specify)