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* 1. First Name

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* 2. Last Name

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* 3. Email Address

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* 4. Do you desire to play a leading role in a private equity buyout?

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* 5. If you answered 'yes' to question #4, have you identified any targets where you and/or your team could significantly enhance the value (which could include the company you work for, a previous employer, or a standalone company that you would like to pursue)?

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* 6. Do you have experience running a business or division of a larger company? If so, please describe including a description of the business, your role, and revenue size of the business.

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* 7. Do you have any prior experience working with private equity groups, including being employed by a company that is owned by a private equity group?

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