Whetstone Application Form Question Title * 1. Please provide us with your contact Information. Your name and title: Company name: Position: Industry: Email address: Phone: OK Question Title * 2. Over the course of the next twelve months, my goals are: 1. 2. 3. 4. 5. OK Question Title * 3. Please list your top THREE challenges. 1. 2. 3. OK Question Title * 4. Most business are in the following stages. Please check the stage which represents where you are at the moment. Growing Stagnant Declining in Growth OK Question Title * 5. Please give reason. OK Question Title * 6. Do you have written business and personal plans? Check if yes. Business Personal OK Question Title * 7. How would you rate yourself? Good OK Poor Ability to plan Ability to plan Good Ability to plan OK Ability to plan Poor Ability to lead/manage Ability to lead/manage Good Ability to lead/manage OK Ability to lead/manage Poor Ability to communicate Ability to communicate Good Ability to communicate OK Ability to communicate Poor Ability to balance life/work activities Ability to balance life/work activities Good Ability to balance life/work activities OK Ability to balance life/work activities Poor Ability to control your own schedule Ability to control your own schedule Good Ability to control your own schedule OK Ability to control your own schedule Poor OK Question Title * 8. Which of the following best describes you? Outgoing Reserved OK Question Title * 9. Which of the following best describes you? People oriented Task oriented OK Question Title * 10. My acceptance into a Whetstone Personal Board of Advisors is important to me because: (Your compelling "Why") OK DONE