Skills & Interest Assessment

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* 1. Contact Information

Name

City/Town

State/Province

ZIP/Postal Code

Email Address

Phone Number

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* 2. How many years of consulting experience do you have?

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* 3. Are you a veteran of the United States military?

Yes

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* 4. Number of clients and projects

	0	1-3	4-6	7-9	10-15	15-20	20+
Current clients	Current clients 0	Current clients 1-3	Current clients 4-6	Current clients 7-9	Current clients 10-15	Current clients 15-20	Current clients 20+
Past clients	Past clients 0	Past clients 1-3	Past clients 4-6	Past clients 7-9	Past clients 10-15	Past clients 15-20	Past clients 20+
Current projects	Current projects 0	Current projects 1-3	Current projects 4-6	Current projects 7-9	Current projects 10-15	Current projects 15-20	Current projects 20+
Past projects	Past projects 0	Past projects 1-3	Past projects 4-6	Past projects 7-9	Past projects 10-15	Past projects 15-20	Past projects 20+

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* 5. How many first degree connections do you have on LinkedIn?

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* 6. Please rate your experience level with these skills/functions.

	Very Low	Low	Average	Moderate	High	NO Experience
Project Management	Project Management Very Low	Project Management Low	Project Management Average	Project Management Moderate	Project Management High	Project Management NO Experience
Project Design	Project Design Very Low	Project Design Low	Project Design Average	Project Design Moderate	Project Design High	Project Design NO Experience
Marketing Strategy	Marketing Strategy Very Low	Marketing Strategy Low	Marketing Strategy Average	Marketing Strategy Moderate	Marketing Strategy High	Marketing Strategy NO Experience
Marketing Execution (Social Media, Hard Copy, Website)	Marketing Execution (Social Media, Hard Copy, Website) Very Low	Marketing Execution (Social Media, Hard Copy, Website) Low	Marketing Execution (Social Media, Hard Copy, Website) Average	Marketing Execution (Social Media, Hard Copy, Website) Moderate	Marketing Execution (Social Media, Hard Copy, Website) High	Marketing Execution (Social Media, Hard Copy, Website) NO Experience
Sales	Sales Very Low	Sales Low	Sales Average	Sales Moderate	Sales High	Sales NO Experience
Sales Management	Sales Management Very Low	Sales Management Low	Sales Management Average	Sales Management Moderate	Sales Management High	Sales Management NO Experience
Leadership Development	Leadership Development Very Low	Leadership Development Low	Leadership Development Average	Leadership Development Moderate	Leadership Development High	Leadership Development NO Experience
Management training	Management training Very Low	Management training Low	Management training Average	Management training Moderate	Management training High	Management training NO Experience
Strategy	Strategy Very Low	Strategy Low	Strategy Average	Strategy Moderate	Strategy High	Strategy NO Experience
Business Planning	Business Planning Very Low	Business Planning Low	Business Planning Average	Business Planning Moderate	Business Planning High	Business Planning NO Experience
Writing	Writing Very Low	Writing Low	Writing Average	Writing Moderate	Writing High	Writing NO Experience
Excel	Excel Very Low	Excel Low	Excel Average	Excel Moderate	Excel High	Excel NO Experience
Budgets	Budgets Very Low	Budgets Low	Budgets Average	Budgets Moderate	Budgets High	Budgets NO Experience
Accounting in general	Accounting in general Very Low	Accounting in general Low	Accounting in general Average	Accounting in general Moderate	Accounting in general High	Accounting in general NO Experience
Quickbooks Online	Quickbooks Online Very Low	Quickbooks Online Low	Quickbooks Online Average	Quickbooks Online Moderate	Quickbooks Online High	Quickbooks Online NO Experience
Quickbooks Desktop	Quickbooks Desktop Very Low	Quickbooks Desktop Low	Quickbooks Desktop Average	Quickbooks Desktop Moderate	Quickbooks Desktop High	Quickbooks Desktop NO Experience
For Profit Fund Raising	For Profit Fund Raising Very Low	For Profit Fund Raising Low	For Profit Fund Raising Average	For Profit Fund Raising Moderate	For Profit Fund Raising High	For Profit Fund Raising NO Experience
Non-Profit Fund Raising	Non-Profit Fund Raising Very Low	Non-Profit Fund Raising Low	Non-Profit Fund Raising Average	Non-Profit Fund Raising Moderate	Non-Profit Fund Raising High	Non-Profit Fund Raising NO Experience
Event Coordination	Event Coordination Very Low	Event Coordination Low	Event Coordination Average	Event Coordination Moderate	Event Coordination High	Event Coordination NO Experience
Feasibility Studies	Feasibility Studies Very Low	Feasibility Studies Low	Feasibility Studies Average	Feasibility Studies Moderate	Feasibility Studies High	Feasibility Studies NO Experience
Curriculum Development	Curriculum Development Very Low	Curriculum Development Low	Curriculum Development Average	Curriculum Development Moderate	Curriculum Development High	Curriculum Development NO Experience
Systems Development	Systems Development Very Low	Systems Development Low	Systems Development Average	Systems Development Moderate	Systems Development High	Systems Development NO Experience

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* 7. Please rate your interest level with these skills/functions.

	Very Low	Low	Average	Moderate	High	NO Interest
Project Management	Project Management Very Low	Project Management Low	Project Management Average	Project Management Moderate	Project Management High	Project Management NO Interest
Project Design	Project Design Very Low	Project Design Low	Project Design Average	Project Design Moderate	Project Design High	Project Design NO Interest
Marketing Strategy	Marketing Strategy Very Low	Marketing Strategy Low	Marketing Strategy Average	Marketing Strategy Moderate	Marketing Strategy High	Marketing Strategy NO Interest
Marketing Execution (Social Media, Hard Copy, Website)	Marketing Execution (Social Media, Hard Copy, Website) Very Low	Marketing Execution (Social Media, Hard Copy, Website) Low	Marketing Execution (Social Media, Hard Copy, Website) Average	Marketing Execution (Social Media, Hard Copy, Website) Moderate	Marketing Execution (Social Media, Hard Copy, Website) High	Marketing Execution (Social Media, Hard Copy, Website) NO Interest
Sales	Sales Very Low	Sales Low	Sales Average	Sales Moderate	Sales High	Sales NO Interest
Sales Management	Sales Management Very Low	Sales Management Low	Sales Management Average	Sales Management Moderate	Sales Management High	Sales Management NO Interest
Leadership Development	Leadership Development Very Low	Leadership Development Low	Leadership Development Average	Leadership Development Moderate	Leadership Development High	Leadership Development NO Interest
Management training	Management training Very Low	Management training Low	Management training Average	Management training Moderate	Management training High	Management training NO Interest
Strategy	Strategy Very Low	Strategy Low	Strategy Average	Strategy Moderate	Strategy High	Strategy NO Interest
Business Planning	Business Planning Very Low	Business Planning Low	Business Planning Average	Business Planning Moderate	Business Planning High	Business Planning NO Interest
Writing	Writing Very Low	Writing Low	Writing Average	Writing Moderate	Writing High	Writing NO Interest
Excel	Excel Very Low	Excel Low	Excel Average	Excel Moderate	Excel High	Excel NO Interest
Budgets	Budgets Very Low	Budgets Low	Budgets Average	Budgets Moderate	Budgets High	Budgets NO Interest
Accounting in general	Accounting in general Very Low	Accounting in general Low	Accounting in general Average	Accounting in general Moderate	Accounting in general High	Accounting in general NO Interest
Quickbooks Online	Quickbooks Online Very Low	Quickbooks Online Low	Quickbooks Online Average	Quickbooks Online Moderate	Quickbooks Online High	Quickbooks Online NO Interest
Quickbooks Desktop	Quickbooks Desktop Very Low	Quickbooks Desktop Low	Quickbooks Desktop Average	Quickbooks Desktop Moderate	Quickbooks Desktop High	Quickbooks Desktop NO Interest
For Profit Fund Raising	For Profit Fund Raising Very Low	For Profit Fund Raising Low	For Profit Fund Raising Average	For Profit Fund Raising Moderate	For Profit Fund Raising High	For Profit Fund Raising NO Interest
Non-Profit Fund Raising	Non-Profit Fund Raising Very Low	Non-Profit Fund Raising Low	Non-Profit Fund Raising Average	Non-Profit Fund Raising Moderate	Non-Profit Fund Raising High	Non-Profit Fund Raising NO Interest
Event Coordination	Event Coordination Very Low	Event Coordination Low	Event Coordination Average	Event Coordination Moderate	Event Coordination High	Event Coordination NO Interest
Feasibility Studies	Feasibility Studies Very Low	Feasibility Studies Low	Feasibility Studies Average	Feasibility Studies Moderate	Feasibility Studies High	Feasibility Studies NO Interest
Curriculum Development	Curriculum Development Very Low	Curriculum Development Low	Curriculum Development Average	Curriculum Development Moderate	Curriculum Development High	Curriculum Development NO Interest
Systems Development	Systems Development Very Low	Systems Development Low	Systems Development Average	Systems Development Moderate	Systems Development High	Systems Development NO Interest

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* 8. Rate your experience level working with or in, these industry sectors.

	Very Low	Low	Average	Moderate	High	No Experience
Producer (Animal)	Producer (Animal) Very Low	Producer (Animal) Low	Producer (Animal) Average	Producer (Animal) Moderate	Producer (Animal) High	Producer (Animal) No Experience
Producer (Vegetable/Crop)	Producer (Vegetable/Crop) Very Low	Producer (Vegetable/Crop) Low	Producer (Vegetable/Crop) Average	Producer (Vegetable/Crop) Moderate	Producer (Vegetable/Crop) High	Producer (Vegetable/Crop) No Experience
Food Manufacturing/ Processing	Food Manufacturing/ Processing Very Low	Food Manufacturing/ Processing Low	Food Manufacturing/ Processing Average	Food Manufacturing/ Processing Moderate	Food Manufacturing/ Processing High	Food Manufacturing/ Processing No Experience
Distribution	Distribution Very Low	Distribution Low	Distribution Average	Distribution Moderate	Distribution High	Distribution No Experience
Aggregation	Aggregation Very Low	Aggregation Low	Aggregation Average	Aggregation Moderate	Aggregation High	Aggregation No Experience
Retail	Retail Very Low	Retail Low	Retail Average	Retail Moderate	Retail High	Retail No Experience
Government (County Development, Department of Ag, etc.)	Government (County Development, Department of Ag, etc.) Very Low	Government (County Development, Department of Ag, etc.) Low	Government (County Development, Department of Ag, etc.) Average	Government (County Development, Department of Ag, etc.) Moderate	Government (County Development, Department of Ag, etc.) High	Government (County Development, Department of Ag, etc.) No Experience
Colleges/ Universities	Colleges/ Universities Very Low	Colleges/ Universities Low	Colleges/ Universities Average	Colleges/ Universities Moderate	Colleges/ Universities High	Colleges/ Universities No Experience
Online Retailer	Online Retailer Very Low	Online Retailer Low	Online Retailer Average	Online Retailer Moderate	Online Retailer High	Online Retailer No Experience
Non-Profit	Non-Profit Very Low	Non-Profit Low	Non-Profit Average	Non-Profit Moderate	Non-Profit High	Non-Profit No Experience
Events	Events Very Low	Events Low	Events Average	Events Moderate	Events High	Events No Experience

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* 9. Rate your interest level working with or in, these industry sectors.

	Very Low	Low	Average	Moderate	High	No Interest
Producer (Animal)	Producer (Animal) Very Low	Producer (Animal) Low	Producer (Animal) Average	Producer (Animal) Moderate	Producer (Animal) High	Producer (Animal) No Interest
Producer (Vegetable/Crop)	Producer (Vegetable/Crop) Very Low	Producer (Vegetable/Crop) Low	Producer (Vegetable/Crop) Average	Producer (Vegetable/Crop) Moderate	Producer (Vegetable/Crop) High	Producer (Vegetable/Crop) No Interest
Food Manufacturing/ Processing	Food Manufacturing/ Processing Very Low	Food Manufacturing/ Processing Low	Food Manufacturing/ Processing Average	Food Manufacturing/ Processing Moderate	Food Manufacturing/ Processing High	Food Manufacturing/ Processing No Interest
Distribution	Distribution Very Low	Distribution Low	Distribution Average	Distribution Moderate	Distribution High	Distribution No Interest
Aggregation	Aggregation Very Low	Aggregation Low	Aggregation Average	Aggregation Moderate	Aggregation High	Aggregation No Interest
Retail	Retail Very Low	Retail Low	Retail Average	Retail Moderate	Retail High	Retail No Interest
Government (County Development, Department of Ag, etc.)	Government (County Development, Department of Ag, etc.) Very Low	Government (County Development, Department of Ag, etc.) Low	Government (County Development, Department of Ag, etc.) Average	Government (County Development, Department of Ag, etc.) Moderate	Government (County Development, Department of Ag, etc.) High	Government (County Development, Department of Ag, etc.) No Interest
Colleges/ Universities	Colleges/ Universities Very Low	Colleges/ Universities Low	Colleges/ Universities Average	Colleges/ Universities Moderate	Colleges/ Universities High	Colleges/ Universities No Interest
Online Retailer	Online Retailer Very Low	Online Retailer Low	Online Retailer Average	Online Retailer Moderate	Online Retailer High	Online Retailer No Interest
Non-Profit	Non-Profit Very Low	Non-Profit Low	Non-Profit Average	Non-Profit Moderate	Non-Profit High	Non-Profit No Interest
Events	Events Very Low	Events Low	Events Average	Events Moderate	Events High	Events No Interest

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* 10. We would like to know how you prefer to organize your professional life. Please rate how comfortable you are working in the following situations.

	Strongly Disagree	Disagree	Neutral	Agree	Strongly Agree
I need to have the same working schedule every week	I need to have the same working schedule every week Strongly Disagree	I need to have the same working schedule every week Disagree	I need to have the same working schedule every week Neutral	I need to have the same working schedule every week Agree	I need to have the same working schedule every week Strongly Agree
I need at least a part-time job	I need at least a part-time job Strongly Disagree	I need at least a part-time job Disagree	I need at least a part-time job Neutral	I need at least a part-time job Agree	I need at least a part-time job Strongly Agree
I need a full-time job	I need a full-time job Strongly Disagree	I need a full-time job Disagree	I need a full-time job Neutral	I need a full-time job Agree	I need a full-time job Strongly Agree
I need a fixed salary	I need a fixed salary Strongly Disagree	I need a fixed salary Disagree	I need a fixed salary Neutral	I need a fixed salary Agree	I need a fixed salary Strongly Agree
I am comfortable working on an as needed basis	I am comfortable working on an as needed basis Strongly Disagree	I am comfortable working on an as needed basis Disagree	I am comfortable working on an as needed basis Neutral	I am comfortable working on an as needed basis Agree	I am comfortable working on an as needed basis Strongly Agree
I am adept at working remotely, unsupervised	I am adept at working remotely, unsupervised Strongly Disagree	I am adept at working remotely, unsupervised Disagree	I am adept at working remotely, unsupervised Neutral	I am adept at working remotely, unsupervised Agree	I am adept at working remotely, unsupervised Strongly Agree
I am flexible with the hours I need to work	I am flexible with the hours I need to work Strongly Disagree	I am flexible with the hours I need to work Disagree	I am flexible with the hours I need to work Neutral	I am flexible with the hours I need to work Agree	I am flexible with the hours I need to work Strongly Agree
I am willing to travel long distance often throughout the year	I am willing to travel long distance often throughout the year Strongly Disagree	I am willing to travel long distance often throughout the year Disagree	I am willing to travel long distance often throughout the year Neutral	I am willing to travel long distance often throughout the year Agree	I am willing to travel long distance often throughout the year Strongly Agree
I prefer being an independent contractor	I prefer being an independent contractor Strongly Disagree	I prefer being an independent contractor Disagree	I prefer being an independent contractor Neutral	I prefer being an independent contractor Agree	I prefer being an independent contractor Strongly Agree
I am comfortable meeting a client in the field...literally	I am comfortable meeting a client in the field...literally Strongly Disagree	I am comfortable meeting a client in the field...literally Disagree	I am comfortable meeting a client in the field...literally Neutral	I am comfortable meeting a client in the field...literally Agree	I am comfortable meeting a client in the field...literally Strongly Agree
I like doughnuts :)	I like doughnuts :) Strongly Disagree	I like doughnuts :) Disagree	I like doughnuts :) Neutral	I like doughnuts :) Agree	I like doughnuts :) Strongly Agree

Is there anything you would like to briefly explain?

Skills & Interest Assessment

Question Title

* 1. Contact Information

Question Title

* 2. How many years of consulting experience do you have?

Question Title

* 3. Are you a veteran of the United States military?

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* 4. Number of clients and projects

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* 5. How many first degree connections do you have on LinkedIn?

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* 6. Please rate your experience level with these skills/functions.

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* 7. Please rate your interest level with these skills/functions.

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* 8. Rate your experience level working with or in, these industry sectors.

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* 9. Rate your interest level working with or in, these industry sectors.

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* 10. We would like to know how you prefer to organize your professional life. Please rate how comfortable you are working in the following situations.

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* 11. Rank in order of preference which opportunities intrigue you about working with Kitchen Table Consultants?

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* 12. How many businesses have you run?

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* 13. How many of these businesses have you owned?

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* 14. How many total years of experience do you have running a business?

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* 15. Have you ever been responsible for laying off or firing employees?

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* 16. Have you ever been fired?