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* 1. Full Name:

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* 2. Type of business you are thinking of starting:

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* 3. Company Name (if you have):

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* 4. Are you planning to start your business with a partner(s)?

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* 5. Do you have a computer at home?

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* 6. Do you have internet?

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* 7. What is your email address:

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* 8. Can you access a computer regularly if you don’t have one?

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* 9. Do you have a cell phone?

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* 10. What is your Cell phone number?

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* 11. Do you ever run out of minutes?

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* 12. Do you have a backup phone?

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* 13. What is your backup phone number?

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* 14. Do you have a home phone?

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* 15. What is your home phone number?

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* 16. Why do you want a mentor?

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* 17. What kind of help do you think a mentor would provide for you and your business?

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* 18. What weaknesses do you have that you think a mentor can help with?

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* 19. Please answer:

  Yes No
Are you prepared to spend 4-6 hours per month communicating with your mentor?
If your mentor wanted to meet in Edmonton, could you do that?
Can you make a 100% commitment that you will always be prepared for your scheduled meeting times with your mentor and that you will NOT cancel without at least 6 hours notice?
Do you understand that your mentor is not a funding source and that they are there for advice and support?
Thank You!

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